This article is more than 5 years old. Information may no longer be current.
Allograft seen as acceptable alternative to autograft for HTO
About 21% of patients undergoing high tibial osteotomy reported pain at the graft harvest site.
Click Here to Manage Email Alerts
Results of a recently presented level 1 study suggest that iliac crest allograft may be a better gap filler option for patients undergoing medial opening-wedge high tibial osteotomy than autograft.
“Iliac crest allograft may be considered as an acceptable substitute for autograft in medial opening, high tibial osteotomy, and this option seems more attractive when the significantly shorter operative time and less donor site morbidity is taken into account,” Ramin Espandar, MD, said during his presentation at the 12th EFORT Congress 2011.
Randomized, clinical study
To compare the efficacy and safety of iliac crest allograft with iliac crest autograft in medal opening-wedge high tibial osteotomy, Espandar and his colleagues selected 46 patients with genovarum deformities and randomized them to receive either allograft or autograft. The surgeons used proximal tibial T-plates for each procedure.
The researchers studied the anatomical indices of the proximal tibias, the complications of each treatment and functional outcomes using the WOMAC index. The investigators followed the patients for 12 months postoperatively.
Length of surgery
The team found no significant difference between either group regarding the amount of correction, loss of correction and time to union. Both groups had improved WOMAC scores postoperatively. Neither group had a neither nonunion nor delayed union.
However, the allograft group had a significantly shorter surgery than the autograft group. The procedure took 52.9 minutes for the allograft group vs. 66.6 minutes for the autograft cohort.
The researchers found comparable complications between the groups. In the allograft group, one patient had a superficial wound infection at the osteotomy site.
“On the other hand, one patient in the autograft group also had the same problem at the graft harvest site,” Espandar said.
Three patients had scars at the graft harvest site and approximately 21% of patients (five patients) complained of pain at the graft harvest site, Espandar said. — by Renee Blisard
Reference:
- Espandar R, Mortazavi SMJ; Kaseb MH, et al. Efficacy and safety of iliac crest allograft in medial opening-wedge high tibial osteotomy compared to iliac crest autograft: A randomized controlled trial. Paper #1554. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen.
- Ramin Espandar, MD, can be reached at Keshavarz Blvd., Imam University Hospital, Tehran, 1419733141, Iran; +98 (21) 6119 2767; email: espandarmd@sina.tums.ac.ir.
- Disclosure: This study was funded by a contribution of the Vice Chancellor of Research at the Tehran University of Medical Sciences. Neither the vice chancellor nor the university had a role in the design, conduct of the study, data analysis or reporting of the results.