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dc.contributor.authorLash, Nicholasen
dc.contributor.authorFeller, Julianen
dc.contributor.authorBatty, Lachlanen
dc.contributor.authorWasiak, Jasonen
dc.contributor.authorRichmond, Annekaen
dc.identifier.citationArthroscopy. 2015 Apr;31(4):720-30en
dc.description.abstractTo establish the rate of use of various void fillers in the setting of opening-wedge osteotomy around the knee, the types of fixation used, and the rates of delayed union or nonunion related to these variables. In addition, this review addressed short-term to midterm outcomes and complication rates associated with such procedures. The electronic databases Medline, Embase, and PubMed were searched using the methodology for systematic review as recommended by the Cochrane Collaboration. The search terms used were as follows: knee, osteotomy, knee joint, bone grafting, opening osteotomy, opening wedge, tibial osteotomy, femoral osteotomy, and bone substitute. We screened 1,383 articles and applied exclusion criteria. Fifty-six articles were included. We included 3,033 cases of osteotomy in 2,910 patients. The mean age of patients was 50 years, with a mean follow-up period of 42 months. Male patients comprised 52% of patients. The mean alignment change was 10.8°, shifting the mechanical axis to 5.1° valgus. Delayed union/nonunion rates were 2.6%, 4.6%, and 4.5% for autograft, allograft bone, and synthetic bone substitutes, respectively (P = .03). Delayed union/nonunion rates were significantly lower for autograft compared with allograft (P = .03) and for autograft and allograft compared with synthetic bone substitutes (P < .0001). Non-locking plates (n = 2,148) had a rate of delayed union/nonunion of 3.7% and a mean loss of correction over time of 0.5°. Locking plates (n = 681) had a rate of delayed union/nonunion of 2.6% and a loss of correction of 2.3°. All mean knee outcome scores improved, and an overall complication rate of 14% was found. Opening-wedge osteotomy had good short-term to midterm outcomes with acceptable complication rates. The lowest rates of delayed union/nonunion were in autograft bone-filled osteotomies. Plate type does not appear to affect osteotomy union or loss of correctionen
dc.subjectVoid Fillersen
dc.subjectOpening-Wedge Osteotomyen
dc.subjectKnee Jointen
dc.subjectBone Graftingen
dc.subjectTibial Osteotomyen
dc.subjectFemoral Osteotomyen
dc.subjectBone Substituteen
dc.subjectOpening Osteotomyen
dc.subjectOpening Wedgeen
dc.subjectMusculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia-
dc.titleBone grafts and bone substitutes for opening-wedge osteotomies of the knee: a systematic reviewen
dc.typeJournal Articleen
dc.identifier.journaltitleArthroscopy: The Journal of Arthroscopy and Related Surgeryen
dc.type.studyortrialSystematic Reviewsen
Appears in Collections:Musculoskeletal

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