J Korean Orthop Assoc.  2016 Oct;51(5):395-402. 10.4055/jkoa.2016.51.5.395.

Analysis of the Factors Affecting Bone Union after Open-Wedge High Tibial Osteotomy and Graft Material for Lateral Cortex Fractures

• Seo JH
• Kim DH
• Seo SS
• Kim YG
• Kim OG
• Park BY

• KMID: 2355504
• DOI: http://doi.org/10.4055/jkoa.2016.51.5.395

Abstract

PURPOSE
The purpose of this study was to analyze patient factors including smoking, body mass index, correction angle, graft material, presence of lateral cortex fracture, and age for the effect on bone union after open-wedge high tibial osteotomy and the effect of graft material used for lateral cortex fractures.
MATERIALS AND METHODS
This retrospective study was conducted on 54 patients and 58 cases with osteoarthritic change Kallgren-Lawrence grade 2 or less from May 2012 to June 2014. Average follow-up period was 22 months (14-38 months). The patients were divided into two groups according to patient related factors and graft materials (allograft, n=6; beta-tricalcium phosphate [β-TCP], n=6) used for lateral cortex fractures and were analyzed for the relationship with bone union after open-wedge high tibial osteotomy. Radiographic and clinic analyses were performed, and van Hemert grading was used for grading bone union at 6 weeks, 3 months, 6 months, and 1 year postoperatively.
RESULTS
The non-smoking group and the group without lateral cortex fracture showed significantly higher bone union rates than the control group. No significant clinical or radiological difference was observed between the two groups in 12 cases and the allograft group showed significantly higher rates of union at 6 months and 1 year postoperatively according to the van Hemert grading.
CONCLUSION
Smoking and the presence of a lateral cortex fracture is a risk factor for nonunion in medial open-wedge high tibial osteotomy. The use of allograft material rather than β-TCP for lateral cortex fractures is thought to result in better bone union.

Keyword

knee; osteoarthritis; open wedge high tibial osteotomy; allografts; β-tricalcium phosphate

MeSH Terms

Allografts
Body Mass Index
Follow-Up Studies
Humans
Knee
Osteoarthritis
Osteotomy*
Retrospective Studies
Risk Factors
Smoke
Smoking
Transplants*
Smoke

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