title: Is a synthetic augmentation in medial open wedge high tibial osteotomies superior to no augmentation in terms of bone-healing?
abstract: BACKGROUND
  Medial open-wedge high tibial osteotomy (MOWHTO) is an established method to treat unicompartimental osteoarthritis of the knee joint. However, augmentation of the created tibial gap after osteotomy is controversially discussed.
  
  
  METHODS
  We performed a prospective investigation of 49 consecutive cases of MOWHTO at our department. Patients were divided into two groups: group A consisted of 19 patients while group B consisted of 30 patients. In group A, the augmentation of the opening gap after osteotomy was filled with a synthetic bone graft, whereas group B received no augmentation. As an indicator for bone healing we investigated the non-union rate in our study population and compared the non-union-rate between the two groups.
  
  
  RESULTS
  The non-union rate was 28% in group A (five of 19 patients had to undergo revision) which received synthetic augmentation, while it was 3.3% in group B (one of 30 patients had to undergo revision) which received no augmentation. The difference between the groups was statistically significant (p-value 0.027).
  
  
  CONCLUSIONS
  With regard to bone healing after MOWHTO, synthetic augmentation was not superior to no augmentation in terms of non-union rates after surgery. In fact, we registered a significantly higher rate of non-union after augmentation with synthetic bone graft.
  
  
  METHODS
  III.
authors.forename: Felix
authors.initials: F
authors.lastname: Ferner
authors.forename: Joerg
authors.initials: J
authors.lastname: Dickschas
authors.forename: Helmut
authors.initials: H
authors.lastname: Ostertag
authors.forename: Ulrich
authors.initials: U
authors.lastname: Poske
authors.forename: Judith
authors.initials: J
authors.lastname: Schwitulla
authors.forename: Joerg
authors.initials: J
authors.lastname: Harrer
authors.forename: Wolf
authors.initials: W
authors.lastname: Strecker
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D019736:Prostheses and Implants; D011474:Prosthesis Design; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Augmentation; High tibial osteotomy; Knee; Osteoarthritis; Synthetic bone graft