Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 5/2018

10.01.2018 | Expert's Opinion • KNEE - BIOMATERIALS

Minimally invasive opening wedge tibia outpatient osteotomy, using screw-to-plate locking technique and a calcium phosphate cement

verfasst von: Claude Schwartz

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Abstract

Medial knee osteoarthritis on angular varus deformity of a lower limb is very common. Open-wedge high tibial osteotomy is a treatment of choice if cartilage is not excessively worn (Allback 1 or 2). The technique based on a plate fixation and the bone defect filled with calcium phosphate cement is thoroughly described. Data at 1, 3, 6 months and 1 year of a 19 cases continuous and prospective series are collected and analysed. Mean age at the time of operation was 55 years. The average preoperative varus deformity was 5° and corrected to an average postoperative valgus of 4° (range 3°–6°). Each control includes the collection of eventual complications, the measurement of health status (quality of life and functional scores) and antero-posterior and lateral X-rays. All osteotomies were considered healed at 6 weeks without any correction loss except one, probably result of a technical error. There was no difference in clinical and functional results between the group and the literature, but the final result occurred earlier in the treatment when the bone defect was filled with either calcium phosphate cement. Faster recovery involved no specific complication and enabled outpatient treatment in a majority of patients.
Literatur
1.
Zurück zum Zitat Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354CrossRefPubMed Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354CrossRefPubMed
2.
Zurück zum Zitat Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE (2005) High tibial osteotomy. J Am Acad Orthop Surg 13(4):279–289CrossRefPubMed Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE (2005) High tibial osteotomy. J Am Acad Orthop Surg 13(4):279–289CrossRefPubMed
3.
Zurück zum Zitat Flecher X, Parratte S, Aubaniac JM, Argenson JN (2006) A 12–28-years followup study of closing wedge high tibial osteotomy. Clin Orthop Relat Res 452:91–96CrossRefPubMed Flecher X, Parratte S, Aubaniac JM, Argenson JN (2006) A 12–28-years followup study of closing wedge high tibial osteotomy. Clin Orthop Relat Res 452:91–96CrossRefPubMed
4.
Zurück zum Zitat Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H (2008) The long-term outcome of high tibial osteotomy—a ten- to 20-year follow-up. J Bone Joint Surg 90B(5):592–596CrossRef Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H (2008) The long-term outcome of high tibial osteotomy—a ten- to 20-year follow-up. J Bone Joint Surg 90B(5):592–596CrossRef
5.
Zurück zum Zitat Spahn G, Klinger HM, Harth p et al (2012) Cartilage regeneration after high tibial osteotomy. Results of an arthroscopic study. Z Orthop Unf 150(3):272–279CrossRef Spahn G, Klinger HM, Harth p et al (2012) Cartilage regeneration after high tibial osteotomy. Results of an arthroscopic study. Z Orthop Unf 150(3):272–279CrossRef
6.
Zurück zum Zitat Jung WH, Takeuchi R, Chun CW et al (2014) Second-look arthroscopic assessment of cartilage regeneration after medial opening-wedge high tibial osteotomy. Arthroscopy 30(1):72–79CrossRefPubMed Jung WH, Takeuchi R, Chun CW et al (2014) Second-look arthroscopic assessment of cartilage regeneration after medial opening-wedge high tibial osteotomy. Arthroscopy 30(1):72–79CrossRefPubMed
7.
Zurück zum Zitat Giuseffi SA, Replogle WH, Shelton WR (2015) Opening-wedge high tibial osteotomy: review of 100 consecutive cases. Arthroscopy 31(11):2128–2137CrossRefPubMed Giuseffi SA, Replogle WH, Shelton WR (2015) Opening-wedge high tibial osteotomy: review of 100 consecutive cases. Arthroscopy 31(11):2128–2137CrossRefPubMed
8.
Zurück zum Zitat Ahlbäck S (1968) Osteoarthrosis of the knee: a radiographic investigation. Acta Radiol Stockh Suppl 277:7–72 Ahlbäck S (1968) Osteoarthrosis of the knee: a radiographic investigation. Acta Radiol Stockh Suppl 277:7–72
9.
Zurück zum Zitat Odenbring S, Berggren AM, Peil L (1993) Roentgenographic assessment of the hip–knee–ankle axis in medial gonarthrosis. A study of reproducibility. Clin Orthop Relat Res 289:195–196 Odenbring S, Berggren AM, Peil L (1993) Roentgenographic assessment of the hip–knee–ankle axis in medial gonarthrosis. A study of reproducibility. Clin Orthop Relat Res 289:195–196
10.
Zurück zum Zitat Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264 Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264
11.
Zurück zum Zitat Bajammal SS et al (2008) The use of calcium phosphate bone cement in fracture treatment. A meta-analysis of randomized trials. J Bone Joint Surg Am 90(6):1186–1196CrossRefPubMed Bajammal SS et al (2008) The use of calcium phosphate bone cement in fracture treatment. A meta-analysis of randomized trials. J Bone Joint Surg Am 90(6):1186–1196CrossRefPubMed
12.
Zurück zum Zitat Goff T, Kanakaris NK, Giannoudis PV (2013) Use of bone graft substitutes in the management of tibial plateau fractures. Injury 44(Suppl 1):S86–S94CrossRefPubMed Goff T, Kanakaris NK, Giannoudis PV (2013) Use of bone graft substitutes in the management of tibial plateau fractures. Injury 44(Suppl 1):S86–S94CrossRefPubMed
13.
Zurück zum Zitat Johal HS, Buckley RE, Le IL, Leighton RK (2009) A prospective randomized controlled trial of a bioresorbable calcium phosphate paste (alpha-BSM) in treatment of displaced intra-articular calcaneal fractures. J Trauma 67(4):875–882CrossRefPubMed Johal HS, Buckley RE, Le IL, Leighton RK (2009) A prospective randomized controlled trial of a bioresorbable calcium phosphate paste (alpha-BSM) in treatment of displaced intra-articular calcaneal fractures. J Trauma 67(4):875–882CrossRefPubMed
14.
Zurück zum Zitat Thawrani D, Thai CC, Welch RD, Copley L, Johnston CE (2009) Successful treatment of unicameral bone cyst by single percutaneous injection of alpha-BSM. J Pediatr Orthop 29(5):511–517CrossRefPubMed Thawrani D, Thai CC, Welch RD, Copley L, Johnston CE (2009) Successful treatment of unicameral bone cyst by single percutaneous injection of alpha-BSM. J Pediatr Orthop 29(5):511–517CrossRefPubMed
15.
Zurück zum Zitat Mattsson P, Larsson S (2006) Calcium phosphate cement for augmentation did not improve results after internal fixation of displaced femoral neck fractures: a randomized study of 118 patients. Acta Orthop 77:251–256CrossRefPubMed Mattsson P, Larsson S (2006) Calcium phosphate cement for augmentation did not improve results after internal fixation of displaced femoral neck fractures: a randomized study of 118 patients. Acta Orthop 77:251–256CrossRefPubMed
16.
Zurück zum Zitat Johal HS, Buckley RE, Le IL, Leighton RK (2009) A prospective randomized controlled trial of a bioresorbable calcium phosphate paste (alpha-BSM) in treatment of displaced intra-articular calcaneal fractures. J Trauma 67:875–882CrossRefPubMed Johal HS, Buckley RE, Le IL, Leighton RK (2009) A prospective randomized controlled trial of a bioresorbable calcium phosphate paste (alpha-BSM) in treatment of displaced intra-articular calcaneal fractures. J Trauma 67:875–882CrossRefPubMed
17.
Zurück zum Zitat Lobenhoffer P, Gerich T, Witte F, Tscherne H (2002) Use of an injectable calcium phosphate bone cement in the treatment of tibial plateau fractures: a prospective study of twenty-six cases with twenty month mean follow-up. J Orthop Trauma 16(3):143–149CrossRefPubMed Lobenhoffer P, Gerich T, Witte F, Tscherne H (2002) Use of an injectable calcium phosphate bone cement in the treatment of tibial plateau fractures: a prospective study of twenty-six cases with twenty month mean follow-up. J Orthop Trauma 16(3):143–149CrossRefPubMed
18.
Zurück zum Zitat Horstmann WG, Verheyen CC, Leemans R (2003) An injectable calcium phosphate cement as a bone-graft substitute in the treatment of displaced lateral tibial plateau fractures. Injury 34(2):141–144CrossRefPubMed Horstmann WG, Verheyen CC, Leemans R (2003) An injectable calcium phosphate cement as a bone-graft substitute in the treatment of displaced lateral tibial plateau fractures. Injury 34(2):141–144CrossRefPubMed
19.
Zurück zum Zitat Keating JF, Hajducka CL, Harper J (2003) Minimal internal fixation and calcium-phosphate cement in the treatment of fractures of the tibial plateau. A pilot study. J Bone Joint Surg Br 85(1):68–73CrossRefPubMed Keating JF, Hajducka CL, Harper J (2003) Minimal internal fixation and calcium-phosphate cement in the treatment of fractures of the tibial plateau. A pilot study. J Bone Joint Surg Br 85(1):68–73CrossRefPubMed
20.
Zurück zum Zitat Elsner A, Jubel A, Prokop A, Koebke J, Rehm KE, Andermahr J (2005) Augmentation of intraarticular calcaneal fractures with injectable calcium phosphate cement: densitometry, histology, and functional outcome of 18 patients. J Foot Ankle Surg 44(5):390–395CrossRefPubMed Elsner A, Jubel A, Prokop A, Koebke J, Rehm KE, Andermahr J (2005) Augmentation of intraarticular calcaneal fractures with injectable calcium phosphate cement: densitometry, histology, and functional outcome of 18 patients. J Foot Ankle Surg 44(5):390–395CrossRefPubMed
21.
Zurück zum Zitat Bloemers FW, Stahl JP, Sarkar MR, Linhart W, Rueckert U, Burhart U, Wippermann BW (2004) Bone substitution and augmentation in trauma surgery with a resorbable calcium phosphate bone cement. Eur J Trauma 30:17–22CrossRef Bloemers FW, Stahl JP, Sarkar MR, Linhart W, Rueckert U, Burhart U, Wippermann BW (2004) Bone substitution and augmentation in trauma surgery with a resorbable calcium phosphate bone cement. Eur J Trauma 30:17–22CrossRef
22.
Zurück zum Zitat Frayssinet P, Schwartz C (1998) Histological study of calcium phosphate ceramics implanted in human long bones. In: Legros RZ, Legros JP (eds) Bioceramics, vol 11. World Scientific Publishing Co Ltd, Singapore, pp 353–357 Frayssinet P, Schwartz C (1998) Histological study of calcium phosphate ceramics implanted in human long bones. In: Legros RZ, Legros JP (eds) Bioceramics, vol 11. World Scientific Publishing Co Ltd, Singapore, pp 353–357
23.
Zurück zum Zitat Frayssinet P, Schwartz C, Beya B et al (1999) Biology of the calcium phosphate integration in human long bones. Eur J Orthop Surg Traumatol 9:167–170CrossRef Frayssinet P, Schwartz C, Beya B et al (1999) Biology of the calcium phosphate integration in human long bones. Eur J Orthop Surg Traumatol 9:167–170CrossRef
24.
Zurück zum Zitat Sarkar MR, Wachter N, Patka P, Kinzl L (2001) First histological observations on the incorporation of a novel calcium phosphate bone substitute material in human cancellous bone. J Biomed Mater Res 58(3):329–334CrossRefPubMed Sarkar MR, Wachter N, Patka P, Kinzl L (2001) First histological observations on the incorporation of a novel calcium phosphate bone substitute material in human cancellous bone. J Biomed Mater Res 58(3):329–334CrossRefPubMed
Metadaten
Titel
Minimally invasive opening wedge tibia outpatient osteotomy, using screw-to-plate locking technique and a calcium phosphate cement
verfasst von
Claude Schwartz
Publikationsdatum
10.01.2018
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2018
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-017-2109-3

Weitere Artikel der Ausgabe 5/2018

European Journal of Orthopaedic Surgery & Traumatology 5/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.