{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:04:15Z","timestamp":1793322255767,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2009,1,23]],"date-time":"2009-01-23T00:00:00Z","timestamp":1232668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We evaluated the clinical outcomes, in terms of early weight bearing, of using opening wedge high tibial osteotomy (OWHTO) to treat spontaneous osteonecrosis of the medial femoral condyle of the knee (SONK) using TomoFix\u2122 and artificial bone substitute. Damaged cartilage tissue was removed and drilling of the necrotic area followed by OWHTO was performed in 30\u00a0knees from 30 patients with an average age of 71 years (range 58\u201382) at the time of operation. Patients were allowed to undertake partial weight\u2010bearing exercises 1 week after the osteotomy procedure, with all patients performing full weight\u2010bearing exercise at 2 weeks post\u2010surgery. The mean follow\u2010up period was 40\u00a0months (range 24\u201362). All of the SONK patients could walk with a full weight\u2010bearing load, using only a T\u2010cane, at 2 weeks after undergoing OWHTO. Clinical assays, including the mean American Knee Society Score and Function Score, showed significant improvements from 51 to 93 points, and 58 to 93 points, respectively. Prior to surgery, the average femoro\u2010tibial angle (FTA) during standing was 181 (1\u00b0 anatomical varus) and had significantly changed to 170 (10\u00b0 valgus) at the time of follow\u2010up. There were no cases of non\u2010union, or implant failure in any of our patients. In addition, none of the patients could sit in the Japanese style prior to surgery, but 21 of 30 patients (70%) could do so after treatment. Arthroscopic findings could be observed in 24 out of 30 cases at implant removal. Necrotic area in each case was covered with fibrous cartilage\u2010like tissue completely. Drilling of the necrotic area followed by OWHTO with TomoFix and artificial bone substitute is an effective treatment for SONK as it results in pain alleviation and regeneration of the fibrous cartilage tissue over the necrotic legion. In addition, an early weight\u2010bearing exercise program is possible after this procedure and full weight\u2010bearing can be achieved at two weeks after surgery.<\/jats:p>","DOI":"10.1007\/s00167-008-0698-4","type":"journal-article","created":{"date-parts":[[2009,1,22]],"date-time":"2009-01-22T09:59:07Z","timestamp":1232618347000},"page":"361-368","source":"Crossref","is-referenced-by-count":48,"title":["Clinical results and radiographical evaluation of opening wedge high tibial osteotomy for spontaneous osteonecrosis of the knee"],"prefix":"10.1002","volume":"17","author":[{"given":"Ryohei","family":"Takeuchi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery School of Medicine Yokohama City University 3\u20109 Fukuura, Kanazawa\u2010ku 236\u20100004 Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Aratake","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery School of 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