High Tibial Osteotomy (HTO)
RHigh Tibial Osteotomy (HTO)
High Tibial Osteotomy (HTO) is a surgical procedure used to correct knee malalignment and relieve pressure on the knee joint, often due to osteoarthritis in one compartment of the knee. There are two main types of HTO: closing-wedge and opening-wedge. In opening-wedge HTO, an osteotomy is made in the upper part of the tibia, creating a wedge-shaped space. Allograft bone wedges are used to fill this space, providing the necessary structural support and stimulating bone healing in the osteotomy site.
- This study compared the use of iliac crest autograft and allograft as gap fillers in medial opening wedge HTO in 46 patients. The results showed comparable efficacy and safety between the two methods, with similar correction amounts, recurrence rates, complication rates, symptom-free time, and radiologic union time.
- The study investigates the use of a press-fit structural bone allograft in HTO surgery, finding that it leads to reduced postoperative pain levels, early ambulation, and excellent short-term clinical outcomes. These findings challenge the general perception of HTO as a painful procedure with a slow recovery, suggesting it as a valuable option for preserving joints.
- The study evaluates the use of a bone wedge in medial opening-wedge HTO, in place of the traditional autogenous iliac crest bone graft. It was found that the allograft led to bone union in an average of 12.1 weeks with a low nonunion rate, demonstrating its efficacy as a graft choice. The procedure also showed low complication rates, with no instances of infection, wound-healing problems, arthrofibrosis, or neurovascular injuries.
- The study found that the use of an allograft wedge in medial opening wedge HTO procedures, especially for larger corrections (>10°), resulted in superior biomechanical stability, withstood higher peak forces, lower valgus malrotation, and higher stiffness, compared to osteotomies without a graft.