Full Text:   <3477>

CLC number: R68

On-line Access: 

Received: 2009-04-05

Revision Accepted: 2009-06-29

Crosschecked: 2009-08-06

Cited: 5

Clicked: 5877

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2009 Vol.10 No.9 P.689-695

http://doi.org/10.1631/jzus.B0920095


Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee


Author(s):  Hai-ning ZHANG, Jie ZHANG, Cheng-yu LV, Ping LENG, Ying-zhen WANG, Xiang-da WANG, Chang-yao WANG

Affiliation(s):  Department of Joint Surgery, the Affiliated Hospital, School of Medicine, Qingdao University, Qingdao 266003, China; more

Corresponding email(s):   zhhaining@hotmail.com

Key Words:  Osteotomy, Varus, Osteoarthritis, Fixation


Hai-ning ZHANG, Jie ZHANG, Cheng-yu LV, Ping LENG, Ying-zhen WANG, Xiang-da WANG, Chang-yao WANG. Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee[J]. Journal of Zhejiang University Science B, 2009, 10(9): 689-695.

@article{title="Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee",
author="Hai-ning ZHANG, Jie ZHANG, Cheng-yu LV, Ping LENG, Ying-zhen WANG, Xiang-da WANG, Chang-yao WANG",
journal="Journal of Zhejiang University Science B",
volume="10",
number="9",
pages="689-695",
year="2009",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B0920095"
}

%0 Journal Article
%T Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee
%A Hai-ning ZHANG
%A Jie ZHANG
%A Cheng-yu LV
%A Ping LENG
%A Ying-zhen WANG
%A Xiang-da WANG
%A Chang-yao WANG
%J Journal of Zhejiang University SCIENCE B
%V 10
%N 9
%P 689-695
%@ 1673-1581
%D 2009
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0920095

TY - JOUR
T1 - Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee
A1 - Hai-ning ZHANG
A1 - Jie ZHANG
A1 - Cheng-yu LV
A1 - Ping LENG
A1 - Ying-zhen WANG
A1 - Xiang-da WANG
A1 - Chang-yao WANG
J0 - Journal of Zhejiang University Science B
VL - 10
IS - 9
SP - 689
EP - 695
%@ 1673-1581
Y1 - 2009
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0920095


Abstract: 
Objective: To introduce and characterize the modified biplanar opening high tibial osteotomy with rigid fixation to treat varus knee in young and active patients. Methods: Between June 2001 to July 2008, 18 patients with monocompartmental degeneration of the knee combined with a varus malalignment of the leg had the modified biplanar opening high tibial osteotomy and the osteotomy was fixed with the locking plates (Locking Compression Plate System). The mean varus deformity before operation was 11.5° (5°~19°) and no degenerative changes were found in other departments. Stability of the knee was normal in 15 patients, but ruptures in anterior cruciate ligaments or lateral collateral ligament were presented in the remaining 3 patients. Preoperative symptom was mainly limited in the pain of medial compartment. The preoperative and follow-up data for the range of motion and Lysholm score were determined. Subjective satisfactory examination was also applied to the patients for the operation they selected. Results: All of the patients were followed up with an average of 32.5 months (12~82 months). There was no ununion or delayed union in this group during the follow-up period. No complications like broken plate, nerve injury, or blood vessel injury occurred. The postoperative average corrected degree was 9.5° (5.5°~18°). No degenerations developed in the three departments of the knee. The Lysholm scores before and after surgery were 42.5 and 77.5, respectively (P<0.01). The overall fineness rate was 83.3%. The subjective satisfactory survey demonstrated that about 83.3% patients showed satisfactory on the operation. There was no obvious difference in the range of motion before and after operation, but significant changes were found in the Lysholm score and varus degree from preoperative to follow-up. Conclusion: Proximal opening high tibial osteotomy performed in conjunction with the special rigid locking plate yielded good results for symptomatic genu varum. This new classic technique can be effectively applied to the medial compartment degeneration of the knee in active young patients.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1] Aglietti, P., Rinonapoli, E., Stringa, G., Taviani, A., 1983. Tibial osteotomy for the varus osteoarthritis knee. Clin. Orthop. Relat. Res., 176:239-251.

[2] Asik, M., Sen, C., Kilic, B., Goksan, S.B., Ciftci, F., Taser, O.F., 2006. High tibial osteotomy with Puddu plate for the treatment of varus gonarthrosis. Knee Surg. Sports Traumatol. Arthrosc., 14(10):948-954.

[3] Billings, A., Scott, D.F., Camargo, M.P., Hofmann, A.A., 2000. High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion. J. Bone Joint Surg. Am., 82:70-79.

[4] Coventry, M.B., 1965. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. J. Bone Joint Surg. Am., 47:984-990.

[5] Devgan, A., Marya, K.M., Kundu, Z.S., Sangwan, S.S., Siwach, R.C., 2003. Medial opening wedge high tibial osteotomy for osteoarthritis of knee: long-term results in 50 knees. Med. J. Malaysia, 58(1):62-68.

[6] El-Azab, H., Halawa, A., Anetzberger, H., Imhoff, A.B., Hinterwimmer, S., 2008. The effect of closed- and open-wedge high tibial osteotomy on tibial slope: a retrospective radiological review of 120 cased. J. Bone Joint Surg. Br., 90(9):1193-1197.

[7] Esenkaya, I., Elmali, N., 2006. Proximal tibia medial open-wedge osteotomy using plates with wedges: early results in 58 cases. Knee Surg. Sports Traumatol. Arthrosc., 14(10):955-961.

[8] Fowler, P.J., Tan, J.L., Brown, G.A., 2000. Medical opening wedge high tibial osteotomy: how I do it? Oper. Tech. Sports Med., 8(1):32-38.

[9] Fujisawa, Y., Masuhara, K., Shiomi, S., 1979. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop. Clin. North Am., 10(3):585-608.

[10] Herningou, P., Medevill, D., Debeyre, J., Goutallier, D., 1987. Proximal tibial osteotomy with varus deformity: a ten to thirteen year follow-up study. J. Bone Joint Surg. Am., 69:332-354.

[11] Insall, J.N., Joseph, D.M., Msika, C., 1984. High tibial osteotomy for varus gonarthrosis. J. Bone Joint Surg. Am., 66:1040-1048.

[12] Kim, S.J., Mahajan, R.H., Park, K.Y., Kim, T.E., Lee, D.H., Choi, W.J., 2007. Biplanar medial open-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a novel technique and follow-up. Oper. Tech. Orthop., 17(1):29-37.

[13] Koshino, T., Murase, T., Takagi, T., Saito, T., 2001. New bone formation around porous hydroxyapatite wedge implanted in opening wedge high tibial osteotomy in patients with osteoarthritis. Biomaterials, 22(12):1579-1582.

[14] Koshino, T., Murase, T., Saito, T., 2003. Medial opening wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee. J. Bone Joint Surg. Am., 85(1):78-85.

[15] Langenbeck, B., 1854. Die subkutane osteotomie. Dtsch Klinik, 6(1):327 (in German).

[16] Lobenhoffer, P., Agneskirchner, J., Zoch, W., 2004. Open valgus alignment osteotomy of the proximal tibia with fixation by medial plate fixator. Orthopade, 33(2): 153-160.

[17] Lysholm, J., Gillquist, J., 1982. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am. J. Sports Med., 10(3):150-154.

[18] Madan, S., Ranjith, U.K., Fiddian, N.J., 2002. Intermediate follow-up of high tibial osteotomy: a comparison of two techniques. Bull. Hosp. Joint Dis., 61:11-16.

[19] Marti, C.B., Gautier, E., Wachtl, S.W., Jakob, R.P., 2004. Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy, 20(4): 366-372.

[20] Muller, W., Kentsch, A., Schafer, N., 2000. The elastic high tibia valgus osteotomy in the varus deformity. Oper. Tech. Sports Med., 8(1):19-26.

[21] Nakamura, E., Mizuta, H., Kudo, S., Takagi, K., Sakamoto, K., 2001. Open-wedge osteotomy of the proximal tibial hemicallotasis. J. Bone Joint Surg. Br., 83(8):1111-1115.

[22] Niemeyer, P., Koestler, W., Kaehny, C., Kreuz, P.C., Brooks, C.J., Strohm, P.C., Helwig, P., Suedkamp, N.P., 2008. Two-year results of open-wedge high tibial osteotomy with fixation by medial plate fixator for medial compartment arthritis with varus malalignment of the knee. Arthroscopy, 24(7):796-804.

[23] Rinonapoli, E., Mancini, G.B., Corvaglia, A., Musiello, S., 1998. Tibial osteotomy for varus gonarthrosis: A 10- to 21-year followup study. Clin. Orthop. Relat. Res., 353:185-193.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE