PreprintArticleVersion 1Preserved in Portico This version is not peer-reviewed
Opening-Wedge High Tibial Osteotomy with Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara. Results from a Cohort of 29 Patients
Version 1
: Received: 2 May 2024 / Approved: 6 May 2024 / Online: 6 May 2024 (07:58:22 CEST)
How to cite:
Depaoli, A.; Ramella, M.; Menozzi, G. C.; Di Gennaro, G. L.; Rocca, G.; Trisolino, G. Opening-Wedge High Tibial Osteotomy with Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara. Results from a Cohort of 29 Patients. Preprints2024, 2024050209. https://doi.org/10.20944/preprints202405.0209.v1
Depaoli, A.; Ramella, M.; Menozzi, G. C.; Di Gennaro, G. L.; Rocca, G.; Trisolino, G. Opening-Wedge High Tibial Osteotomy with Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara. Results from a Cohort of 29 Patients. Preprints 2024, 2024050209. https://doi.org/10.20944/preprints202405.0209.v1
Depaoli, A.; Ramella, M.; Menozzi, G. C.; Di Gennaro, G. L.; Rocca, G.; Trisolino, G. Opening-Wedge High Tibial Osteotomy with Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara. Results from a Cohort of 29 Patients. Preprints2024, 2024050209. https://doi.org/10.20944/preprints202405.0209.v1
APA Style
Depaoli, A., Ramella, M., Menozzi, G. C., Di Gennaro, G. L., Rocca, G., & Trisolino, G. (2024). Opening-Wedge High Tibial Osteotomy with Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara. Results from a Cohort of 29 Patients. Preprints. https://doi.org/10.20944/preprints202405.0209.v1
Chicago/Turabian Style
Depaoli, A., Gino Rocca and Giovanni Trisolino. 2024 "Opening-Wedge High Tibial Osteotomy with Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara. Results from a Cohort of 29 Patients" Preprints. https://doi.org/10.20944/preprints202405.0209.v1
Abstract
Background: Infantile tibia vara (ITV) is a rare proximal tibia deformity in infancy, leading to progressive knee varus. High tibial osteotomy is commonly practiced but has high recurrence rates. This study analyzed factors affecting treatment failure and recurrence in children undergoing opening-wedge high tibial osteotomy (OWHTO) for ITV. Methods: We retrospectively studied children with ITV who had OWHTO with press-fit cancellous bone allograft between 2000 and 2020, with ≥2-year follow-up. Outcomes included recurrence (knee varus with tibiofemoral angle >10°), complications, and reintervention. Results: We analyzed 39 knees in 29 patients (mean age: 4.8 ± 1.9 years; median follow-up: 7.4 years). Recurrence occurred in 22 cases (56%). Age at surgery significantly influenced recurrence, with rates of 16% before age 5 versus 95% later (hazard ratio: 12.0, p = 0.001). Langenskiöld stage also affected recurrence (β-coefficient: 2.7, 95% C.I. 1.0–4.5, p = 0.002; pseudo-R-squared: 0.50, p = 0.001), with recurrence in all stage III IV or higher cases. Conclusions: Early diagnosis and treatment before age 45, ideally with Langenskiöld stage III or lower, are crucial for stable correction with OWHTO alone. Late, high-grade ITV may require combined, acute or gradual, and/or staged correction. Further evidence is needed for optimal management.
Medicine and Pharmacology, Orthopedics and Sports Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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