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Comparative analysis of fixation configurations and their effect on outcome after medial open-wedge high tibial osteotomy.

Authors
  • Lee, Eui Soo1
  • Kim, Tae Woo1
  • Jo, In Ho2
  • Lee, Yong Seuk3
  • 1 Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, South Korea. , (North Korea)
  • 2 Department of Orthopaedic Surgery, Pyeongchon Woori Hospital, South Korea. , (North Korea)
  • 3 Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, South Korea. Electronic address: [email protected] , (North Korea)
Type
Published Article
Journal
Journal of Orthopaedic Science
Publisher
Elsevier
Publication Date
Jul 01, 2020
Volume
25
Issue
4
Pages
627–634
Identifiers
DOI: 10.1016/j.jos.2019.06.018
PMID: 31320145
Source
Medline
Language
English
License
Unknown

Abstract

The purposes of this study were to analyze and compare 1) the postoperative fixation configurations, and 2) radiological and clinical outcomes between the new conceptual fixation device (LCfit) and the conventional locking plates. Retrospective comparative analysis of 304 cases who underwent open-wedge high tibial osteotomy with four different locking plate systems including the LCfit system was conducted. In analyzing the fixation configuration of each locking plate system, the plate position, the gap between plate and bone, screw angle, and screw length were evaluated from postoperative CT scans. The clinical outcomes and radiological parameters of four patient groups corresponding to the four locking plate systems were also compared. In the analysis of the fixation configurations, the LCfit system showed more posteromedial plate position, decreased gap between plate and bone, reduced screw angle, and longer screw length compared to the other three locking plates. However, there were no significant differences in clinical outcomes and radiological parameters such as hip-knee-ankle angle, weight-bearing line position, medial proximal tibial angle, and posterior slope between the four groups. The newly designed fixation system (LCfit) for open-wedge high tibial osteotomy showed fixation configurations that have theoretical mechanical advantages over conventional anatomical locking plates. However, there were no significant differences in clinical outcomes and radiological parameters between LCfit and the other locking plate systems. Level III, retrospective cohort study. Copyright © 2019 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

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