15-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plate

Background: Medial Open Wedge-High Tibial Osteotomy (MOW-HTO) has been universally accepted as treatment of choice for adults with medial joint Osteoarthritis (OA) and varus malalignment. TomoFix locking plate (Depuy Synthes) was popularised in the early 2000 which boasted about better fixation with...

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Main Authors: Woon-Hwa Jung, Aniket Wagh, Minseok Seo, Ryohei Takeuchi
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Orthopaedic Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X24002327
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author Woon-Hwa Jung
Aniket Wagh
Minseok Seo
Ryohei Takeuchi
author_facet Woon-Hwa Jung
Aniket Wagh
Minseok Seo
Ryohei Takeuchi
author_sort Woon-Hwa Jung
collection DOAJ
description Background: Medial Open Wedge-High Tibial Osteotomy (MOW-HTO) has been universally accepted as treatment of choice for adults with medial joint Osteoarthritis (OA) and varus malalignment. TomoFix locking plate (Depuy Synthes) was popularised in the early 2000 which boasted about better fixation with lesser complications and early weight bearing. The main aim of this research is to study 15-year long term follow-up results of MOW-HTO with TomoFix plate and analyse the survival rate, complications, and possible risk factors. Materials and methods: Retrospective study enrolling 91 patients who underwent MOW-HTO with TomoFix between January to June 2009. Complications were noted. Clinical and radiological parameters were documented and analysed. 71 patients were followed up for 15 years. Kaplan Meier Survival Analysis and Log-Rank test were performed to evaluate the survival rate. Cox Regression Analysis was used to identify possible individual factors affecting the survival of the procedure. Results: Mean age of the study population was 59.83 ± 7.68 years. Fourteen (19.72 %) patients were converted to Total Knee Replacement (TKR), showing that the original procedure survived in 80.28 % of the patients at the end of 15 years. Kaplan Meier analysis estimated a survival rate of 75.75 % at the end of 20 years. Log-Rank test showed significant difference (p < 0.05) in survival between grade 3 and 4 of knee OA. According to Cox Regression Analysis, OA grade and Body Mass Index (BMI) were found to be the risk factors for HTO survival. The complication rate was 19.72 %, all of which could be managed conservatively. Conclusion: MOW-HTO with TomoFix plate proves to be an excellent biological option to conserve the native knee joint and should be the first choice of management in medial joint arthritis with varus malalignment in adults.
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spelling doaj-art-a59e94c814cd48d4a64cb746f922ba8c2025-08-20T03:31:24ZengElsevierJournal of Orthopaedic Reports2773-157X2025-04-014110053710.1016/j.jorep.2024.10053715-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plateWoon-Hwa Jung0Aniket Wagh1Minseok Seo2Ryohei Takeuchi3Department of Orthopaedic Surgery, Murup Hospital, Changwon, South Korea; Corresponding author. Department of Orthopaedic Surgery, Murup Hospital, 2-52, 3 Ga Jungang-dong, Masanhappo-gu, 631-423, Changwon-si, Gyeongnam, South Korea.Arthroplasty and Arthroscopy Fellow, Department of Orthopaedic Surgery, Murup Hospital, Changwon, South KoreaDepartment of Orthopaedic Surgery, Murup Hospital, Changwon, South KoreaDepartment of Orthopaedic Surgery, School of Medicine, Yokohama City University, Yokohama, JapanBackground: Medial Open Wedge-High Tibial Osteotomy (MOW-HTO) has been universally accepted as treatment of choice for adults with medial joint Osteoarthritis (OA) and varus malalignment. TomoFix locking plate (Depuy Synthes) was popularised in the early 2000 which boasted about better fixation with lesser complications and early weight bearing. The main aim of this research is to study 15-year long term follow-up results of MOW-HTO with TomoFix plate and analyse the survival rate, complications, and possible risk factors. Materials and methods: Retrospective study enrolling 91 patients who underwent MOW-HTO with TomoFix between January to June 2009. Complications were noted. Clinical and radiological parameters were documented and analysed. 71 patients were followed up for 15 years. Kaplan Meier Survival Analysis and Log-Rank test were performed to evaluate the survival rate. Cox Regression Analysis was used to identify possible individual factors affecting the survival of the procedure. Results: Mean age of the study population was 59.83 ± 7.68 years. Fourteen (19.72 %) patients were converted to Total Knee Replacement (TKR), showing that the original procedure survived in 80.28 % of the patients at the end of 15 years. Kaplan Meier analysis estimated a survival rate of 75.75 % at the end of 20 years. Log-Rank test showed significant difference (p < 0.05) in survival between grade 3 and 4 of knee OA. According to Cox Regression Analysis, OA grade and Body Mass Index (BMI) were found to be the risk factors for HTO survival. The complication rate was 19.72 %, all of which could be managed conservatively. Conclusion: MOW-HTO with TomoFix plate proves to be an excellent biological option to conserve the native knee joint and should be the first choice of management in medial joint arthritis with varus malalignment in adults.http://www.sciencedirect.com/science/article/pii/S2773157X24002327Medial open wedgeHigh tibial osteotomyTomoFixKaplan meierHTOVarus malalignment
spellingShingle Woon-Hwa Jung
Aniket Wagh
Minseok Seo
Ryohei Takeuchi
15-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plate
Journal of Orthopaedic Reports
Medial open wedge
High tibial osteotomy
TomoFix
Kaplan meier
HTO
Varus malalignment
title 15-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plate
title_full 15-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plate
title_fullStr 15-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plate
title_full_unstemmed 15-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plate
title_short 15-Year survival rate of medial open wedge- high tibial osteotomy with TomoFix plate
title_sort 15 year survival rate of medial open wedge high tibial osteotomy with tomofix plate
topic Medial open wedge
High tibial osteotomy
TomoFix
Kaplan meier
HTO
Varus malalignment
url http://www.sciencedirect.com/science/article/pii/S2773157X24002327
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AT aniketwagh 15yearsurvivalrateofmedialopenwedgehightibialosteotomywithtomofixplate
AT minseokseo 15yearsurvivalrateofmedialopenwedgehightibialosteotomywithtomofixplate
AT ryoheitakeuchi 15yearsurvivalrateofmedialopenwedgehightibialosteotomywithtomofixplate