• Arch Orthop Trauma Surg · Jul 2024

    Randomized Controlled Trial Comparative Study

    Equal rates of bone healing and reduced surgical time with iliac crest allograft compared to autograft in medial opening wedge high tibial osteotomy: a randomized controlled clinical trial.

    • Rafael Erthal de Paula, Rodrigo Sattamini Pires E Albuquerque, Alan de Paula Mozella, Ricardo Duran Sobral, Valente MaiaPhelippe AugustoPAKnee Specialized Attendance Center, National Institute of Traumatology and Orthopedics (INTO), Avenida Brasil 500 - Caju, Rio de Janeiro, 20940-070, Brazil., Rafael Augusto Dantas Prinz, Arnaldo Cézar Couto, Idemar Monteiro da Palma, Hugo Alexandre de Araujo Barros Cobra, de SousaEduardo BrancoEBKnee Specialized Attendance Center, National Institute of Traumatology and Orthopedics (INTO), Avenida Brasil 500 - Caju, Rio de Janeiro, 20940-070, Brazil., and Aline Cordeiro.
    • Knee Specialized Attendance Center, National Institute of Traumatology and Orthopedics (INTO), Avenida Brasil 500 - Caju, Rio de Janeiro, 20940-070, Brazil. erthalortopedia@gmail.com.
    • Arch Orthop Trauma Surg. 2024 Jul 1; 144 (7): 305330613053-3061.

    IntroductionIliac crest autograft is frequently used to fill in bone defects after osteotomies. Nonetheless, surgery for bone autograft procurement is associated with morbidity and pain at the donor site. Alternatives to it have been explored, but there is no consensus to guide their application as a routine practice in several orthopedic procedures. Thus, this study was designed to compare the efficacy and safety between iliac crest autograft and allograft in medial opening wedge high tibial osteotomy.Materials And MethodsForty-seven patients with a symptomatic unilateral genu varum and an indication for high tibial osteotomy were randomly assigned to receive either autograft or allograft to fill the osteotomy site. Operative time, bone healing, and complication rates (delayed union, nonunion, superficial and deep infection, loss of correction, and hardware failure) were recorded after a one-year follow-up. Data were expressed as Mean ± Standard Deviation and considered statistically significant when p < 0.05.ResultsThe time to radiologic union was similar between both groups (Allograft: 2.38 ± 0.97 months vs. Autograft: 2.45 ± 0.91 months; p = 0.79). Complication rates were also similar in both groups, with one infection in the allograft group and two in the autograft group, two delayed unions in the allograft group, and three in the autograft group. The operative time differed by 11 min between the groups, being lower in the allograft group (Allograft: 65.4 ± 15.1 min vs. Autograft: 76.3 ± 15.2 min; p = 0.02).ConclusionIliac crest allografts can be safely and effectively used in medial opening wedge high tibial osteotomy as it promotes the same rates of bone union as those achieved by autologous grafts, with the benefits of a shorter operative time.Trial Registration NumberU1111-1280-0637 1 December 2022, retrospectively registered.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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