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High tibial osteotomy for the treatment of medial osteoarthritis of the knee with new iBalance system: 2 years of follow-up

  • Original Article • KNEE - OSTEOTOMY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

A new system for performing open-wedge high tibial osteotomy (HTO), the iBalance HTO System-Arthrex, has been recently developed in order to make the surgery more reproducible and safe. The aim of this study was to determine the short-term outcomes of the iBalance technique in medial compartment osteoarthritis and varus malalignment of the knee.

Methods

Fifteen patients with a mean age of 50.7 years (SD 5.09), affected by symptomatic varus knee, with medial compartment osteoarthritis (1–2 Ahlbäck degree), were treated with iBalance HTO between July 2011 and February 2012 and evaluated retrospectively. Patients were assessed against the following benchmarks: subjective International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and VAS for pain and Tegner scores, along with X-rays and MRI, before surgery and after a 2-year follow-up.

Results

No severe intraoperative complications or implant failures occurred. The mean preoperative scores were as follows: subjective IKDC 66.8 (SD 1.18), KOOS 61.3 (SD 0.86), Vas for pain 8.6 (SD 1.72) and Tegner 4.1 (SD 2.06), while at follow-up the scores were 73.6 (SD 1.01), 88.1 (SD 1.23), 2.9 (SD 2.35) and 3.1 (SD 1.83), respectively. Correction ranged between 3° and 8°. All patients showed complete articular recovery, no loss of correction, no substantial variation in A/P slope and no hardware problems.

Conclusions

iBalance proved to be effective and safe and produced good overall results. Consolidation and osseointegration of the system took place rapidly, while recovery was precocious, comparable with traditional methods and with no severe complications.

Level of evidence

Case series, Level IV.

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Authors and Affiliations

  1. San Marino ISS - State Hospital, Via Vittorio Scialoja no 40, 47893, Borgo Maggiore, CA, San Marino

    Diego Ghinelli

  2. Rizzoli Orthopaedic Institute, Via Pupilli, 1, 40134, Bologna, Italy

    Alessandro Parma, Matteo Baldassarri, Alessandra Olivieri, Massimiliano Mosca, Gherardo Pagliazzi & Roberto Buda

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  1. Diego Ghinelli
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  2. Alessandro Parma
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Correspondence to Matteo Baldassarri.

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Conflict of interest

Diego Ghinelli MD, Alessandro Parma MD, Matteo Baldassarri MD, Alessandra Olivieri MD, Massimiliano Mosca MD, Gherardo Pagliazzi MD, Roberto Emanuele Buda Prof. MD declared that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ghinelli, D., Parma, A., Baldassarri, M. et al. High tibial osteotomy for the treatment of medial osteoarthritis of the knee with new iBalance system: 2 years of follow-up. Eur J Orthop Surg Traumatol 26, 523–535 (2016). https://doi.org/10.1007/s00590-016-1768-9

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  • DOI: https://doi.org/10.1007/s00590-016-1768-9

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