{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:11:24Z","timestamp":1784815884292,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the benefits of vancomycin\u2010soaked femoral head allograft versus allogenic bone chips as an osteotomy gap filler in reducing infection rates and perioperative pain control after medial opening wedge high tibial osteotomy (MOW\u2010HTO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of 114\u00a0knees that underwent MOW\u2010HTO between 2013 and 2020. Osteotomy gaps were filled with vancomycin\u2010soaked femoral head allograft (Study Group) or allogenic bone chips (Control Group). Both groups received systemic antibiotics. Perioperative parameters studied included pain, blood loss, length of stay, postoperative day (POD1) pain scores at rest, with activity as well as ambulatory distance. Patients in the Study Group were also followed up prospectively and clinical outcome scores, namely Knee Society Score, Oxford knee score (OKS) and Physical and Mental Component of the Short\u2010Form 36 Questionnaire (PCS and MCS, respectively). Statistical analyses using Student\u2019s <jats:italic>T<\/jats:italic>\u2010test were performed between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients of the study group had significantly better POD1 visual analogue scale (VAS) at rest (0.9\u2009\u00b1\u20091.6 vs 2.9\u2009\u00b1\u20091.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) as well as when active (3.0\u2009\u00b1\u20091.9 vs 5.8\u2009\u00b1\u20091.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). A greater proportion of patients in the study group ambulated on POD 1, (90.6% vs 26.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Of those who ambulated on POD1, study group patients managed to cover a greater ambulatory distance (13.9\u2009\u00b1\u20097.4\u00a0m vs 8.4\u2009\u00b1\u20099.3\u00a0m, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The proportion of study group patients requiring patient\u2010controlled analgesia (PCA) was also significantly less compared to the control group (32.8% vs 58.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Of those requiring PCA, the amount of morphine requirement was also significantly reduced in the group with vancomycin\u2010soaked allograft (8.7\u2009\u00b1\u20098.1\u00a0mg vs 23.9\u2009\u00b1\u200933.0\u00a0mg, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The study group also had a reduced length of stay (3.5\u2009\u00b1\u20092.0\u00a0days vs 5.5\u2009\u00b1\u20092.6\u00a0days, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patients in the study group demonstrated significant improvement in Knee Society Knee Score (KSKS), OKS, PCS and MCS at 12\u00a0months postoperatively. The study group had a significantly reduced incidence of superficial wound infections compared to the control group (3.1% vs 18.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vancomycin\u2010soaked femoral head allograft reduced superficial and deep wound infections in MOW\u2010HTO. It was also effective in reducing postoperative pain, thereby enabling early ambulation and shorter hospital stays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Retrospective comparative study, III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06885-9","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T13:08:38Z","timestamp":1643893718000},"page":"4054-4062","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Vancomycin\u2010soaked femoral head allograft in opening wedge high tibia osteotomy enables earlier postoperative recovery and reduces infection rates compared to allogenic bone chips"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-675X","authenticated-orcid":false,"given":"Don Thong Siang","family":"Koh","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kong Hwee","family":"Lee","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,3]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010012\u20102084\u20105"},{"key":"e_1_2_9_3_2","first-page":"614","article-title":"Biostatistics 104: correlational analysis","volume":"44","author":"Chan YH","year":"2003","journal-title":"Singap Med J"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.10.FOCUS18470"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058\u20105241.6.200059"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200203000\u201000020"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010011\u20101768\u20103"},{"key":"e_1_2_9_8_2","first-page":"E355","article-title":"Modern indications, results, and global trends in the use of unicompartmental knee arthroplasty and high tibial osteotomy in the treatment of isolated medial compartment osteoarthritis","volume":"45","author":"Zuiderbaan HA","year":"2016","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.11.009"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.03.071"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.02.020"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005463\u2010w"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201005943\u20104"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.01.002"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00188"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2009.07.026"},{"key":"e_1_2_9_17_2","first-page":"17","article-title":"Benefits of early ambulation within 24 h after total knee arthroplasty: a multicenter retrospective cohort study in China","volume":"8","author":"Lei Y\u2010T","year":"2021","journal-title":"Mil Med Res"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.05.592"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201069958\u20100"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590\u2010018\u20102280\u20101"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504269034"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105323\u20106"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103438\u2010y"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2020.01.005"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.4103\/0019\u20105413.98833"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010008\u20100773\u20109"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.01.065"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1086\/600877"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.16.028"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006199\u20108"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20104297\u20105"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010003\u20100588\u20107"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968\u20100160(01)00097\u20107"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005765\u2010z"},{"key":"e_1_2_9_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2015.09.018"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-06885-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-022-06885-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-06885-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-022-06885-9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T11:00:32Z","timestamp":1760871632000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-022-06885-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,3]]},"references-count":34,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1007\/s00167-022-06885-9"],"URL":"https:\/\/doi.org\/10.1007\/s00167-022-06885-9","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,3]]},"assertion":[{"value":"25 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 January 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that no conflicts of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This single centre retrospective study was approved by the hospital\u2019s ethics committee (CIRB:2020\/2705) and carried out in accordance with the ethical standards established in the 1964 Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}