title: Opening-wedge high tibial osteotomy with a secure bone allograft (Osteopure™) and locked plate fixation: Retrospective clinical and radiological evaluation of 69 knees after 7.5years follow-up.
abstract: BACKGROUND
  Medial opening-wedge high tibial osteotomy (OWHTO) provides reliable and long-lasting benefits, despite the wide range of wedge-filling and internal-fixation techniques used. The purpose of this work was to assess the clinical and radiological outcomes in a case-series of OWHTO performed using a secure bone allograft and locked plate fixation.
  
  
  OBJECTIVE
  The clinical and radiological outcomes of OWHTO with a high-safety bone allograft and locked plate fixation are similar to those reported in previous case-series studies.
  
  
  METHODS
  A single-centre retrospective design was used to study 69 knees in 64 patients with a mean age of 51.8years (31-53years) and a preoperative hip-knee-ankle (HKA) angle of 173° (165°-180°). The wedge was filled with secure Osteopure™ bone allograft and fixation was achieved using an Integra Surfix(®) locked plate. Mean follow-up was 7.5years (5-9.3years). Clinical and functional outcomes were assessed by determining the IKS and KOOS-PS scores and recording complications related or unrelated to the allograft. The main criterion for assessing OWHTO survival was the time to revision surgery for symptom recurrence. Radiological assessment criteria were the HKA angle, tibial slope, patellar height, and osteoarthritis grade. GESTO criteria were used to evaluate the behaviour of the allograft.
  
  
  RESULTS
  Of the 69 knees, 64 (92.8%) were re-evaluated. The survival rate after 9.3years was 95%±2.7% (3 failures managed with arthroplasty). The functional IKS score improved significantly, by 20 points (P<0.001). Mean increases of 7.8° for the HKA angle and 3.5° for tibial slope were recorded. Bone healing without radiological abnormalities was consistently achieved within 6months. There were no complications related to the allograft (infections, allergies; local or systemic toxicity).
  
  
  CONCLUSIONS
  The clinical, radiological, and safety outcomes documented in our study were similar to those reported in earlier work.
  
  
  METHODS
  IV, retrospective case-series study.
authors.affiliation: Service d'orthopédie-traumatologie, CHU Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: G
authors.initials: G
authors.lastname: Villatte
authors.affiliation: Service d'orthopédie-traumatologie, CHU Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: R
authors.initials: R
authors.lastname: Erivan
authors.affiliation: Service d'orthopédie-traumatologie, CHU Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: P-L
authors.initials: PL
authors.lastname: Fournier
authors.affiliation: Service Biostatistique, CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: B
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Service d'orthopédie-traumatologie, CHU Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: Galvin
authors.affiliation: Service d'orthopédie-traumatologie, CHU Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France; Laboratoire C-Biosenss, EA 4676, Université d'Auvergne 1, 63000 Clermont-Ferrand, France.
authors.forename: S
authors.initials: S
authors.lastname: Descamps
authors.affiliation: Service d'orthopédie-traumatologie, CHU Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: sboisgard@chu-clermontferrand.fr.
authors.forename: S
authors.initials: S
authors.lastname: Boisgard
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery; D001860:Bone Plates; D016025:Bone Transplantation / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D007717:Knee; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013639:Tarsal Bones / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors
keywords: Bone allograft; Medial opening-wedge high tibial osteotomy; Outcomes