The role of bone void fillers in medial opening wedge high tibial osteotomy: a systematic review

Omer Slevin, Olufemi R. Ayeni, Stefan Hinterwimmer, Thomas Tischer, Matthias J. Feucht, Michael T. Hirschmann
  • Knee Surgery Sports Traumatology Arthroscopy, August 2016, Springer Science + Business Media
  • DOI: 10.1007/s00167-016-4297-5

Bone void fillers in opening wedge high tibial osteotomy - is it necessary and safe to use them?

What is it about?

This is a systematic review about the question if it is necessary and safe to use bone void fillers (autograft, allograft or synthetics) in high tibial osteotomy. The rate of bone healing, delayed and non-union was assessed with regards to opening gap size in a large patient cohort.

Why is it important?

High tibial osteotomy (HTO) is used to make a straight leg from bowed legs. This aims for correction of loading within the joint and preventing osteoarthritis progression. When doing opening wedge HTO one creates gaps on the medial side. The bone gap can be left alone or filled with a variety of bone void fillers such as allograft, autograft or synthetics.


Dr Michael Tobias Hirschmann (Author)
Kantonsspital Baselland

This is a frequently asked question in high tibial osteotomy (HTO) surgery. Is it necessary to, which and when to use bone void fillers in HTO. This systematic review gives you strong evidence by hand showing that the use of bone void fillers is not necessary to an opening gap size of 12mm. Furthermore, it shows that the rate of non-union was highest in the synthetics group.

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The following have contributed to this page: Dr Michael Tobias Hirschmann