Uniplane medial opening wedge high tibial osteotomy relative to a biplane osteotomy can reduce the incidence of lateral-hinge fracture
ESSKA Academy. Kyung B. 11/08/19; 284355; epEKA-05 Topic: Open Surgery
Dr. Bong Soo Kyung
Dr. Bong Soo Kyung
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Uniplane medial opening wedge high tibial osteotomy relative to a biplane osteotomy can reduce the incidence of lateral-hinge fracture

ePoster - epEKA-05

Topic: HTO

Nha K.W.1, Shin M.J.1, Suh D.W.2, Nam Y.J.1, Kim K.S.3, Kyung B.S.2
1Ilsanpaik Hospital, Inje University, Department of Orthopaedic Surgery, Ilsan, Gyeonggi-do, Korea, Republic of, 2Barunsesang Hospital, Joint center, Seongnam-si, Gyeonggi-do, Korea, Republic of, 3Janghowon St. Mary's Hospital, Department of Orthopaedic Surgery, Icheon, Gyeonggi-do, Korea, Republic of

Purpose: With surgical modifications reflecting plate design differences of the specific rigid locking plate adding a metal wedge, uniplane high tibial osteotomy(HTO) has fewer lateral-hinge fractures and fewer plate irritations than biplane HTO.
Methods: Uniplane HTO with a rigid locking plate adding a metal wedge was compared with biplane HTO with a rigid locking plate including a proximal D-hole. For comparison, the HTO patients' medical records and radiological results in a single institution were retrospectively reviewed. The Oxford knee score 2 years post-operation, CT scan at post-operative day 2 and serial standing long-bone scanography were reviewed to evaluate clinical outcome and radiological results, including the incidence of lateral-hinge fracture, plate irritation and correction loss to varus alignment.
Results: A total of 103 knees, including 59 uniplane HTO and 44 biplane HTO, were enrolled. The Oxford scores were 38.1±7.8 in the uniplane group and 35.9±8.3 in the biplane group. (n.s.) On CT scans, more lateral hinge fractures developed in the biplane group, and 7 knees (12%) of the uniplane group and 12 knees (27%) of the biplane group had Takeuchi type I stable hinge fracture (p< 0.05); unstable fracture was not noted in either group. Plate irritation occurred in 9 knees (19%) of the uniplane group and in 14 knees (32%) of the biplane group, and the difference was statistically significant. (p< 0.05)
Conclusion: In clinical situations including the use of surgical modifications reflecting plate design differences, fewer lateral-hinge fractures developed after uniplane medial opening-wedge HTO compared with biplane HTO. Uniplane HTO potentially represents a better option than biplane HTO for the prevention of lateral-hinge fracture.
Uniplane medial opening wedge high tibial osteotomy relative to a biplane osteotomy can reduce the incidence of lateral-hinge fracture

ePoster - epEKA-05

Topic: HTO

Nha K.W.1, Shin M.J.1, Suh D.W.2, Nam Y.J.1, Kim K.S.3, Kyung B.S.2
1Ilsanpaik Hospital, Inje University, Department of Orthopaedic Surgery, Ilsan, Gyeonggi-do, Korea, Republic of, 2Barunsesang Hospital, Joint center, Seongnam-si, Gyeonggi-do, Korea, Republic of, 3Janghowon St. Mary's Hospital, Department of Orthopaedic Surgery, Icheon, Gyeonggi-do, Korea, Republic of

Purpose: With surgical modifications reflecting plate design differences of the specific rigid locking plate adding a metal wedge, uniplane high tibial osteotomy(HTO) has fewer lateral-hinge fractures and fewer plate irritations than biplane HTO.
Methods: Uniplane HTO with a rigid locking plate adding a metal wedge was compared with biplane HTO with a rigid locking plate including a proximal D-hole. For comparison, the HTO patients' medical records and radiological results in a single institution were retrospectively reviewed. The Oxford knee score 2 years post-operation, CT scan at post-operative day 2 and serial standing long-bone scanography were reviewed to evaluate clinical outcome and radiological results, including the incidence of lateral-hinge fracture, plate irritation and correction loss to varus alignment.
Results: A total of 103 knees, including 59 uniplane HTO and 44 biplane HTO, were enrolled. The Oxford scores were 38.1±7.8 in the uniplane group and 35.9±8.3 in the biplane group. (n.s.) On CT scans, more lateral hinge fractures developed in the biplane group, and 7 knees (12%) of the uniplane group and 12 knees (27%) of the biplane group had Takeuchi type I stable hinge fracture (p< 0.05); unstable fracture was not noted in either group. Plate irritation occurred in 9 knees (19%) of the uniplane group and in 14 knees (32%) of the biplane group, and the difference was statistically significant. (p< 0.05)
Conclusion: In clinical situations including the use of surgical modifications reflecting plate design differences, fewer lateral-hinge fractures developed after uniplane medial opening-wedge HTO compared with biplane HTO. Uniplane HTO potentially represents a better option than biplane HTO for the prevention of lateral-hinge fracture.
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