Early results of medial opening wedge high tibial osteotomy using an intraosseous implant with accelerated rehabilitation

Morris, Jodie, Grant, Andrea, Kulkarni, Rohit, Doma, Kenji, Harris, Alicia, and Hazratwala, Kaushik (2019) Early results of medial opening wedge high tibial osteotomy using an intraosseous implant with accelerated rehabilitation. European Journal of Orthopaedic Surgery and Traumatology, 29 (1). pp. 147-156.

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BACKGROUND: Accelerated rehabilitation protocols for medial opening wedge high tibial osteotomy (MOW HTO) using intraosseous implants have not previously been described. The present study provides early clinical and radiological outcomes of MOW HTO using a polyetheretherketone (PEEK) intraosseous system, in combination with an early weight-bearing protocol.

METHODS: Twenty consecutive knees (17 patients) underwent navigated MOW HTO using a PEEK implant with accelerated rehabilitation. Time to union and maintenance of correction were assessed radiographically for 12 months post-operative. Patient outcomes were monitored for a mean follow-up of 38 months (range 23-42) using standardised instruments (WOMAC, IKDC and Lysholm scores).

RESULTS: All knees were corrected to valgus. The mean time to unassisted weight-bearing was 55 days (SD 24, range 21-106). Bone union occurred in 95% of knees by 6 months, with correction maintained for 15 knees at 12 months post-operative. Knees for which correction was lost within 1 year of surgery had significantly greater preoperative varus alignment. Implant survivorship was 95% and 80% at 12 and 38 months post-operative, respectively. Significant improvements in patient-reported satisfaction, knee function and return to daily activities from preoperative to 38 months post-operative were reported (WOMAC 36 v 0; IKDC 35.6 v 96; Lysholm 44.5 v 100).

CONCLUSIONS: Accelerated rehabilitation following MOW HTO with an intraosseous PEEK implant did not delay bone union, with significantly improved functional outcomes within 3 months post-operative. Early findings suggest that this approach may be suitable for a defined patient subset, with consideration for the extent of preoperative genu varum.

Item ID: 57072
Item Type: Article (Research - C1)
ISSN: 1432-1068
Keywords: accelerated rehabilitation; high tibial osteotomy; medial opening wedge; medial osteoarthritis; navigation; PEEK
Copyright Information: Copyright © Springer-Verlag France SAS, part of Springer Nature 2018.
Funders: Orthopaedic Research Institute of Queensland
Date Deposited: 12 Feb 2019 04:39
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320226 Surgery @ 100%
SEO Codes: 92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 100%
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