Comparison of the Efficacy of TomoFix Plate and Common Plate in Medial Open Wedge High Tibial Osteotomy

Ren Zhiqiang; Wang Zhaojun; Li Hongliang; Yang Jinghong; Jiang Lujun; Wang Zi; Liu Juncai; Li Zhong

Abstract：Objective To compare the clinical efficacy of the TomoFix plate versus a common plate in medial opening-wedge high tibial osteotomy(MOWHTO).Methods A retrospective analysis was performed on data from 150 patients with medial knee osteoarthritis(MKOA)who underwent MOWHTO at the Affiliated Hospital of Southwest Medical University between June 2017 and December 2020.Following doctor-patient consultation,patients autonomously chose the plate type and were subsequently divided into two groups:78 patients selected the TomoFix plate(observation group),comprising 33 males and 45 females,with a mean age of(56.7±5.2)years;72 patients chose the common plate(control group),consisting of 30 males and 42 females,with a mean age of(56.6±5.3)years.All patients were aged under 65 years.The perioperative period,visual analogue scale(VAS),Lysholm score,the Western Ontario and McMaster Universities(WOMAC)score,international knee documentation committee(IKDC)score,the hospital for special surgery(HSS)score,range of motion(ROM),and imaging data were compared across both groups.Results Both groups successfully underwent surgery without encountering severe intraoperative complications.The follow-up duration for patients ranged from 12 to 24 months,with a mean of(19.2±4.3)months for the control group and(18.6±3.3)months for the experimental group.No statistically significant difference in follow-up duration was found between the groups(P＞0.05).Furthermore,there were no significant differences between the groups in intraoperative blood loss,fluoroscopy times,postoperative drainage volume,time to weight-bearing,or hospital stay(P＞0.05).However,significant differences were observed in operation time and bone healing time(P＜0.05).Compared to preoperative measurements,both groups demonstrated significant improvements in the femorotibial angle(FTA)and medial proximal tibial angle(MPTA)at the final follow-up(P＜0.05),with no significant changes in the posterior tibial slope(PTS)or medial compartment Kellgren-Lawrence grade(P＞0.05).When comparing the two groups,only the FTA showed a statistically significant difference at the final follow-up(P＜0.05),while MPTA,PTS,and K-L grade did not.Both groups also showed significant improvements in VAS,Lysholm score,WOMAC score,IKDC score,HSS score,and ROM at the final follow-up(P＜0.05).At the final follow-up,significant differences were noted between the groups in VAS,Lysholm score,IKDC score,and knee flexion-extension ROM(P＜0.05),but not in WOMAC or HSS scores(P＞0.05).The complication rate was 6.4％in the observation group and 20.8％in the control group,with a statistically significant difference(P＜0.05).Conclusion The application of TomoFix plate fixation in MOWHTO results in shorter bone healing time and a lower complication rate,leading to satisfactory outcomes,reduced long-term pain,and significant improvement in knee function.