BACKGROUND While open wedge high tibial osteotomy (owHTO) is an established standard procedure to treat medial osteoarthritis of the knee in combination with varus deformity, it bears the risk of postoperative hardware failures and lateral cortical hinge fractures. This in turn can lead to an accelerated osteoarthritis, non-union, or a loss of correction accuracy. The purpose of the study was to evaluate the radiologic outcomes of owHTO with a carbon fiber reinforced poly-ether-ether-ketone (CF-PEEK) plate fixation in patients with medial osteoarthritis and varus deformity. METHODS Three hundred twenty-four consecutive patients (346 knees) who were treated with owHTO using the PEEKPower HTO plate were included in this retrospective study; 89.9% of the patients were overweight or obese. Patients were followed by conventional radiographs over a 12-month period. Typical plate-related results such as the time and quality of gap healing as well as the correction accuracy were analyzed. Furthermore, the number of lateral cortex fractures was determined. RESULTS Bony consolidation was observed after a mean gap healing time of 4.0 ± 1.7 months independent on the patients' weight (p = 0.2302). With increasing gap sizes, bony healing was significantly prolonged (p < 0.001). Additionally, patients with greater gap sizes had a significantly increased risk for a lateral cortex fracture (p = 0.0041). However, none of the patients had a non-union 1 year postoperative. A hinge fracture occurred in 30% of patients. Hinge fractures with Takeuchi grades I and II increased the gap healing time compared to no fracture (p = 0.0069 and p = 0.0002, respectively), but only 1.2% of patients with hinge fracture had a clinical relevant loss of correction ≥ 3 mm. No implant failures were found. CONCLUSIONS Open wedge HTO using the PEEKPower HTO plate for patients with medial osteoarthritis of the knee in combination with tibial varus deformity leads to excellent bony consolidation also in cases with a hinge fracture, a gap size > 12 mm as well as for severely obese patients.

中文翻译：

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碳纤维增强聚醚醚酮（CF-PEEK）钢板固定术治疗楔形高位胫骨截骨术的钢板相关结果：回顾性病例系列，共346膝。

背景技术虽然开放楔形高位胫骨截骨术（owHTO）是治疗膝关节内侧骨关节炎并内翻畸形的公认标准程序，但它具有术后硬体功能衰竭和外侧皮质铰链骨折的风险。这又会导致骨关节炎加速，骨不连或矫正准确性下降。这项研究的目的是评估内侧骨关节炎和内翻畸形患者用碳纤维增强聚醚醚酮（CF-PEEK）钢板固定owHTO的放射学结果。方法这项回顾性研究纳入了使用PEEKPower HTO板进行owHTO治疗的324例连续患者（346膝）。89.9％的患者超重或肥胖。在12个月的时间内对患者进行常规X光片检查。分析了典型的印版相关结果，例如间隙愈合的时间和质量以及校正精度。此外，确定了外侧皮质骨折的数量。结果平均间隙愈合时间为4.0±1.7个月后，与患者的体重无关（p = 0.2302），观察到了骨巩固。随着间隙大小的增加，骨愈合显着延长（p <0.001）。此外，间隙尺寸较大的患者发生外侧皮质骨折的风险显着增加（p = 0.0041）。但是，所有患者术后1年均未发生骨不连。30％的患者发生铰链骨折。与没有骨折相比，Takeuchi I级和II级的铰链骨折增加了间隙愈合时间（p = 0.0069和p = 0。分别为0002），但只有1.2％的铰链骨折患者的临床相关矫正损失≥3 mm。未发现植入失败。结论使用PEEKPower HTO板开放楔形HTO治疗膝关节内侧骨关节炎并伴有胫骨内翻畸形的患者，即使在铰链骨折，间隙大小> 12 mm以及严重肥胖的患者中，也能实现出色的骨巩固性。