Comparison of Autograft vs Allograft in Opening-Wedge High Tibial Osteotomy
Marshall A. Kuremsky, MD, * Thomas M. Schaller, MD, † Christian C. Hall, MD, ‡ Bernard A. Roehr, MD, § and John L. Masonis, MD #
* Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina
† HealthCare Midwest Orthopedic Surgery and Sports Medicine, Kalamazoo, Michigan
‡ Kalamazoo Center for Medical Studies, Michigan State University, Kalamazoo, Michigan
§ Midwest Orthopaedic Surgery P.C., Kalamazoo, Michigan
# OrthoCarolina, Charlotte, North Carolina
The Journal of Arthroplasty Vol. 25 No. 6 2010
Abstract: Opening-wedge high tibial osteotomy (HTO) is used to treat isolated medial knee joint arthritis. A benefit of using allograft instead of autograft is avoiding a second surgical site, thereby decreasing operative time, blood loss, and pain. Our study objective was to evaluate allograft vs autograft in the failure and complication rates of HTO using the same technique and implant system (Arthrex HTO plate system, Arthrex, Inc, Naples, Fla). Seventy knees in 65 patients were evaluated.
There was a 6-fold higher failure rate for the allograft group. When there was no lateral cortical breach, construct failure did not occur in 87.8% of the knees (P = .0006); with lateral cortical breach, construct failure occurred 53% of the time (P = .0006). Seventy-six and a half percent of breached cortices and 75% of failures were associated with large wedge sizes (≥11 mm); this may suggest a role for closing-wedge osteotomy or alternative osteotomies when larger alignment corrections are needed.
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- Stiffness After Revision Total Knee Arthroplasty
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- Comparison of Autograft vs Allograft in Opening-Wedge High Tibial Osteotomy
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