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High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy

BACKGROUND: A fibular shortening osteotomy is needed to perform lateral closing-wedge high tibial osteotomy (LCW-HTO). To achieve this shortening, we have recently developed an acute oblique osteotomy and ligation (AO/L) procedure for the center of the fibular shaft, based on the AO procedure. PURPO...

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Autores principales: Ueda, Daisuke, Yasuda, Kazunori, Kaibara, Takuma, Yabuuchi, Koji, Yamaguchi, Jun, Onodera, Jun, Iwasaki, Norimasa, Yagi, Tomonori, Kondo, Eiji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9382075/
https://www.ncbi.nlm.nih.gov/pubmed/35990872
http://dx.doi.org/10.1177/23259671221117480
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author Ueda, Daisuke
Yasuda, Kazunori
Kaibara, Takuma
Yabuuchi, Koji
Yamaguchi, Jun
Onodera, Jun
Iwasaki, Norimasa
Yagi, Tomonori
Kondo, Eiji
author_facet Ueda, Daisuke
Yasuda, Kazunori
Kaibara, Takuma
Yabuuchi, Koji
Yamaguchi, Jun
Onodera, Jun
Iwasaki, Norimasa
Yagi, Tomonori
Kondo, Eiji
author_sort Ueda, Daisuke
collection PubMed
description BACKGROUND: A fibular shortening osteotomy is needed to perform lateral closing-wedge high tibial osteotomy (LCW-HTO). To achieve this shortening, we have recently developed an acute oblique osteotomy and ligation (AO/L) procedure for the center of the fibular shaft, based on the AO procedure. PURPOSE: To compare the 2-year follow-up outcomes between the AO/L procedure and the AO procedure. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A prospective comparative cohort study was conducted involving 83 patients (83 knees) who underwent shortening osteotomy of the fibula in LCW-HTO between April 2017 and March 2019. The first consecutive 41 knees (AO group) underwent fibular osteotomy with the AO procedure. The remaining 42 knees (AO/L group) underwent fibular osteotomy with the AO/L procedure. All of the patients were evaluated for at least 2 years postoperatively via clinical and radiological assessments. To determine the time needed for complete union at the osteotomy site, we evaluated the radiographs using a radiographic union score for tibial fractures, which was modified for fibular osteotomy. Comparison of outcomes between the 2 groups was performed using the Student t test for continuous variables and the Mann-Whitney U test or Fisher exact test for discrete variables. RESULTS: Around the fibular osteotomy site, no perioperative complications were found in either group. The radiographic union score was significantly higher in the AO/L group than in the AO group (P < .0001 at 2, 3, and 6 months; P = .0290 at 12 and 24 months). The union rate at the fibular osteotomy site was significantly higher in the AO/L group (97.6%) than in the AO group (82.9%) at 12 months (P = .0290). CONCLUSION: The AO/L procedure significantly accelerated the formation of bridging callus at the fibular osteotomy site and provided a significantly higher union rate compared with the AO procedure. Both AO/L and AO procedures were free from perioperative complications. These results suggest that the AO/L procedure is clinically useful as an osteotomy procedure to shorten the fibula in LCW-HTO.
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spelling pubmed-93820752022-08-18 High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy Ueda, Daisuke Yasuda, Kazunori Kaibara, Takuma Yabuuchi, Koji Yamaguchi, Jun Onodera, Jun Iwasaki, Norimasa Yagi, Tomonori Kondo, Eiji Orthop J Sports Med Article BACKGROUND: A fibular shortening osteotomy is needed to perform lateral closing-wedge high tibial osteotomy (LCW-HTO). To achieve this shortening, we have recently developed an acute oblique osteotomy and ligation (AO/L) procedure for the center of the fibular shaft, based on the AO procedure. PURPOSE: To compare the 2-year follow-up outcomes between the AO/L procedure and the AO procedure. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A prospective comparative cohort study was conducted involving 83 patients (83 knees) who underwent shortening osteotomy of the fibula in LCW-HTO between April 2017 and March 2019. The first consecutive 41 knees (AO group) underwent fibular osteotomy with the AO procedure. The remaining 42 knees (AO/L group) underwent fibular osteotomy with the AO/L procedure. All of the patients were evaluated for at least 2 years postoperatively via clinical and radiological assessments. To determine the time needed for complete union at the osteotomy site, we evaluated the radiographs using a radiographic union score for tibial fractures, which was modified for fibular osteotomy. Comparison of outcomes between the 2 groups was performed using the Student t test for continuous variables and the Mann-Whitney U test or Fisher exact test for discrete variables. RESULTS: Around the fibular osteotomy site, no perioperative complications were found in either group. The radiographic union score was significantly higher in the AO/L group than in the AO group (P < .0001 at 2, 3, and 6 months; P = .0290 at 12 and 24 months). The union rate at the fibular osteotomy site was significantly higher in the AO/L group (97.6%) than in the AO group (82.9%) at 12 months (P = .0290). CONCLUSION: The AO/L procedure significantly accelerated the formation of bridging callus at the fibular osteotomy site and provided a significantly higher union rate compared with the AO procedure. Both AO/L and AO procedures were free from perioperative complications. These results suggest that the AO/L procedure is clinically useful as an osteotomy procedure to shorten the fibula in LCW-HTO. SAGE Publications 2022-08-12 /pmc/articles/PMC9382075/ /pubmed/35990872 http://dx.doi.org/10.1177/23259671221117480 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Ueda, Daisuke
Yasuda, Kazunori
Kaibara, Takuma
Yabuuchi, Koji
Yamaguchi, Jun
Onodera, Jun
Iwasaki, Norimasa
Yagi, Tomonori
Kondo, Eiji
High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy
title High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy
title_full High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy
title_fullStr High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy
title_full_unstemmed High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy
title_short High Rate of Radiographic Union at the Fibular Osteotomy Site With No Complications After an Acute Oblique Osteotomy and Ligation Procedure to Shorten the Fibula in High Tibial Osteotomy
title_sort high rate of radiographic union at the fibular osteotomy site with no complications after an acute oblique osteotomy and ligation procedure to shorten the fibula in high tibial osteotomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9382075/
https://www.ncbi.nlm.nih.gov/pubmed/35990872
http://dx.doi.org/10.1177/23259671221117480
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