Document Detail

Correction accuracy and collateral laxity in open versus closed wedge high tibial osteotomy. A one-year randomised controlled study.
MedLine Citation:
PMID:  19707760     Owner:  NLM     Status:  MEDLINE    
In a randomised clinical trial in 50 patients with symptomatic osteoarthritis of the medial compartment of the knee, the clinical results of high tibial osteotomy (HTO) according to the open wedge osteotomy (OWO) and closed wedge osteotomy (CWO) were compared. In both groups locked plate fixation was used. Clinical and radiological assessments were performed preoperatively and after one year. Postoperative hip-knee-ankle (HKA) correction angles were monitored on standing leg X-rays. The effect of HTO on collateral laxity of the knee was measured with a specially designed varus-valgus device. The WOMAC osteoarthritis index, the modified knee society score (KS) and visual analogue scales (VAS) were used to assess symptoms of osteoarthritis, function, pain and patient satisfaction. At one-year follow-up we found accurate corrections in both groups and the planned correction angles were achieved. No loss of correction was observed. Furthermore, the medial collateral laxity and the patellar height significantly decreased after OWO. Significant improvements of WOMAC and KS scores were found in both groups. All patients had significantly less pain and were very satisfied with the results. Surgery time was significantly longer in the CWO group, and complications were more frequent in this group. Both techniques led to good and comparable clinical results. The choice of whether to perform an open or a closed wedge osteotomy may be based on preoperative patellar height or concomitant collateral laxity.
Robert D A Gaasbeek; Loes Nicolaas; Willard J Rijnberg; Corne J M van Loon; Albert van Kampen
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-08-27
Journal Detail:
Title:  International orthopaedics     Volume:  34     ISSN:  1432-5195     ISO Abbreviation:  Int Orthop     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-05-04     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  7705431     Medline TA:  Int Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  201-7     Citation Subset:  IM    
Department of Orthopedics and Traumatology, Meander Medical Center, Ringweg Randenbroek 110, 3816 CP, Amersfoort, The Netherlands.
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MeSH Terms
Arthroplasty / adverse effects,  instrumentation,  methods*
Joint Deformities, Acquired / etiology,  physiopathology,  surgery*
Joint Instability / etiology,  physiopathology
Knee Joint / pathology,  physiopathology,  surgery*
Middle Aged
Osteoarthritis, Knee / complications,  physiopathology,  surgery*
Osteotomy / adverse effects,  instrumentation,  methods*
Pain / etiology,  physiopathology,  surgery
Patella / pathology,  radiography
Postoperative Complications
Recovery of Function
Reproducibility of Results
Severity of Illness Index
Tibia / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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