Radiographic healing with hemispherical allogeneic femoral head bone grafting for opening-wedge high tibial osteotomy.
OBJECTIVE
The aim of this study was to investigate the remodeling process after hemispherical femoral head allograft grafting in opening-wedge high tibial osteotomy with a plate and screw.


METHODS
The study group included 105 knees in 92 women and 7 knees in 7 men from January 2007 through December 2007. The radiographic bone remodeling process was determined by use of a modification of the radiologic rating system described previously by van Hemert et al. in 4 groups: group A, 7-mm plate correction; group B, 9-mm plate correction; group C, 11-mm plate correction; and group D, 13-mm plate correction.


RESULTS
The postoperative femorotibial angle and tibial slope were not significantly changed at latest follow-up in comparison to immediate postoperative status. The mean follow-up period was 25.4 months (range, 18 to 30 months). In all groups radiologic bone healing higher than phase 3 was successfully achieved between 3 and 6 months. The healing process slowed with increasing correction angle.


CONCLUSIONS
A hemispherical femoral head allograft is a good alternative osseous graft material when patients are selected appropriately with the following criteria: body mass index lower than 40, no symptomatic osteoarthritis of the patellofemoral joint and lateral compartment, no systemic inflammatory arthritis, no history of fracture or previous open surgery to the lower limb, and no flexion contracture.


METHODS
Level IV, therapeutic case series.
Department of Orthopaedic Surgery, Mok-Dong Himchan Hospital, Seoul, South Korea.
Kwang Am
KA
Jung
Su Chan
SC
Lee
Nong Kyoum
NK
Ahn
Seung Hyun
SH
Hwang
Chang Hyun
CH
Nam
D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D016723:Bone Remodeling; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005270:Femur Head / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D014184:Transplantation, Homologous