Comparison of Puddu Osteotomy with or Without Autologous Bone Grafting: a Prospective Clinical Trial

Overview

Journal Rev Bras Ortop

Specialty Orthopedics

Date 2017 Oct 25

PMID 29062820

Citations 3

Authors

Marcus Ceregatti Passarelli

Jose Roberto Tonelli Filho

Felipe Augusto Mendes Brizzi

Gustavo Constantino de Campos

Alessandro Rozim Zorzi

Joao Batista de Miranda

Affiliations

Soon will be listed here.

Abstract

Objectives: To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients undergoing medial opening-wedge high tibial osteotomy.

Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. One group received bone graft, and the other group was left without filling the osteotomy defect. The primary outcome was the Knee Society Score. Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes.

Results: There was no difference in KSS scale between the graft group (64.4 ± 21.8) and the graftless group (61.6 ± 17.3; = 0.309). There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft = 184 ± 4.6 degrees, graftless = 183.4 ± 5.1 degrees; = 1.0), indicating that there is no loss of correction due to the lack of the graft. There was significant aggravation of osteoarthritis in a greater number of patients in a graft group ( = 0.005).

Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study.

Citing Articles

No Superior Bone Union Outcomes with Allografts Compared to No Grafts and Autografts Following Medial Opening Wedge High Tibial Osteotomy: A Retrospective Cohort Study.

Mao Y, Yao L, Li J, Li J, Xiong Y Orthop Surg. 2023; 16(2):363-373.

PMID: 38111034 PMC: 10834220. DOI: 10.1111/os.13961.

Bone Grafting Outcomes in Smokers Undergoing High Tibial Osteotomy: A Systematic Review.

Joshi P, Joshi S, Joshi Y, Shenoy P Cureus. 2023; 15(3):e36758.

PMID: 37123765 PMC: 10132770. DOI: 10.7759/cureus.36758.

[Management principle and clinical suggestions of osteotomy gap of opening wedge high tibial osteotomy].

Liu J, Yang L, Wu J, Su W, Zhao J Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020; 34(7):919-926.

PMID: 32666739 PMC: 8180423. DOI: 10.7507/1002-1892.201909110.

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