Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2010 Apr;81(2):193-8.
doi: 10.3109/17453671003619003.

Early full weight bearing is safe in open-wedge high tibial osteotomy

Justus-Martijn Brinkman  1 , Joan W H Luites, Ate B Wymenga, Ronald J van Heerwaarden
Affiliations
Comparative Study

Early full weight bearing is safe in open-wedge high tibial osteotomy

Justus-Martijn Brinkman et al. Acta Orthop. 2010 Apr.

Abstract

Background and purpose: In open-wedge, valgus osteotomy of the upper tibia, there are concerns regarding the initial stability and ability to retain the correction. Rehabilitation protocols vary depending on the osteotomy technique and the fixation method. Angle-stable implants offer superior initial stability. Early full weight bearing appears to be possible using these implants. In this prospective cohort study, we measured migration in open-wedge osteotomy in patients following an early full weight bearing protocol and compared the results to those from a historical cohort of open-wedge osteotomy patients who followed a standard protocol (full weight bearing after 6 weeks) using radiostereometry.

Methods: 14 open-wedge osteotomies fixated with the angle-stable Tomofix implant were performed; patients were allowed full weight bearing as soon as pain and wound healing permitted. Radiostereometry was used to measure motion across the osteotomy at regular intervals. Improvement in pain and functional outcome were assessed postoperatively. The results were compared to those from a group of 23 patients who had undergone the same operation but had used a standard rehabilitation protocol.

Results: There were no adverse effects because of the early full weight bearing protocol. There were no differences in motion at the osteotomy between groups as measured by radiostereometry. In both groups, pain and function improved substantially without any differences between groups. Patients in the early weight bearing group achieved the same result but in a shorter time.

Interpretation: Tomofix-plate-fixated open-wedge high tibial osteotomy allows early full weight bearing without loss of correction.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
The OW-HTO, Tomofix implant and tantalum beads used for RSA.
Figure 2.
Figure 2.
The 6 possible directions of migration are shown schematically. T: transalation in mm; R: rotation in degrees; x: transverse axis; y: longitudinal axis; z: sagittal axis.
See this image and copyright information in PMC

References

    1. Agneskirchner JD, Freiling D, Hurschler C, Lobenhoffer P. Primary stability of four different implants for opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2006;14:291–300. - PubMed
    1. Asik M, Sen C, Kilic B, Goksan SB, Ciftci F, Taser OF. High tibial osteotomy with Puddu plate for the treatment of varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc. 2006;14:948–54. - PubMed
    1. Brinkman JM, Lobenhoffer P, Agneskirchner JD, Staubli AE, Wymenga AB, van Heerwaarden RJ. Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. J Bone Joint Surg (Br) 2008;90:1548–57. - PubMed
    1. Gaasbeek RD, Welsing RT, Verdonschot N, Rijnberg WJ, van Loon CJ, van Kampen A. Accuracy and initial stability of open- and closed-wedge high tibial osteotomy: a cadaveric RSA study. Knee Surg Sports Traumatol Arthrosc. 2005;13:689–94. - PubMed
    1. Hernigou P, Medevielle D, Debeyre J, Goutallier D. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg (Am) 1987;69:332–54. - PubMed

Publication types

MeSH terms

LinkOut - more resources