Simoultaneous bilateral medial opening wedge high tibial osteotomy can be performed safely and effectively without bone grafting: analysis of a monocentric retrospective series

双侧内侧开放楔形高位胫骨截骨术无需植骨即可安全有效地同时进行:一项单中心回顾性系列研究的分析

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Abstract

BACKGROUND: Simultaneous bilateral high tibial osteotomy (SBHTO) is a potential solution to treat bilateral medial osteoarthritis (OA) associated with tibial varus deformity. Concerns on the potential problems related to bone healing exists, and most of the surgeon performing SBHTO use bone void filler as associated procedure. This paper aim to evaluate safety and efficacy of SBHTO using locking plate, autologous cancellous bone mobilization and no bone void filler with immediate weight bearing at tolerance protocol. METHODS: Consecutive patients performing primary SBHTO between January 2019 and December 2022 were retrospectively evaluated. Functional and pain score, subjective satisfaction and complications were noted at 2, 3, 6 months and final follow up, with a minimum of 12 months. RESULTS: A total of 40 patients (80 knees) were included. Mean correction for each limb was 8.67° ± 2.24°. No patients presented with major complications. Pain was reduced but activity level worsened 2 months after surgery. All pain and functional scores improved significantly from months 3 up to final follow up. 95% of patients reported to be subjectively satisfied with surgery. CONCLUSIONS: This paper showed that SBHTO can be performed safely and with good results without bone grafting the osteotomy gap, even for correction up to 12°. Pain improved already 2 months after surgery, while activity level and function start to improve at 3 months after surgery. LEVEL OF EVIDENCE: IV.

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