title: Comparison between two angular stable locking plates for medial opening-wedge high tibial osteotomy: Decisive wedge locking plate versus TomoFix™.
abstract: BACKGROUND
  An adequate stable fixation implant should be used for medial opening-wedge high tibial osteotomy (MOWHTO) to promote rapid bone healing without complications. This study compared the radiographic and clinical outcomes as well as plate-specific complications between two angular stable locking plates in patients following MOWHTO.
  
  
  METHODS
  This prospective study involved 97 patients (50 with DWL®, group I; 47 with TomoFix™, group II) undergoing MOWHTO for primary medial compartment osteoarthritis between 2010 and 2013. Clinical and radiographic evaluations were performed by using the HSS and WOMAC scores, and calculating mechanical femorotibial angle (mFTA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), and posterior tibial slope (PTS) on radiographs both preoperatively and after 3 years.
  
  
  RESULTS
  A statistically significant difference was observed for the MPTA at the last follow-up between the two groups (P = 0.033). Additionally, the last follow-up MPTA of group I was associated with the osteotomy technique (P = 0.004) and preoperative JLCA (P = 0.034) whereas the last follow-up MPTA of group II was associated with gender (P = 0.001) and BMI (P = 0.008). Furthermore, the results showed that group I had a higher rate of non-union (4%) compared to that in group II (0%).
  
  
  CONCLUSIONS
  Both locking plates are useful tools in the treatment of medial compartment knee osteoarthritis with varus deformity in young, active patients. However, under special consideration of the complication we found in present study, the TomoFix™ seems to be a better alternative in using the MOWHTO for highly demanding patients.
authors: Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Republic of Korea.
authors: Young-Soo
authors: YS
authors: Shin
authors: Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Republic of Korea.
authors: Keong-Ho
authors: KH
authors: Kim
authors: Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Republic of Korea.
authors: Hyun-Bo
authors: HB
authors: Sim
authors: Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Republic of Korea. Electronic address: momyjr@naver.com.
authors: Jung-Ro
authors: JR
authors: Yoon
mesh_terms: D000368:Aged; D001860:Bone Plates; D015331:Cohort Studies; D016001:Confidence Intervals; D004867:Equipment Design / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D056910:Republic of Korea; D012720:Severity of Illness Index; D013977:Tibia / Q000601:surgery*