{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T09:31:57Z","timestamp":1792315917011,"version":"4.4.0"},"reference-count":64,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T00:00:00Z","timestamp":1421193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T00:00:00Z","timestamp":1421193600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T00:00:00Z","timestamp":1421193600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["arthroscopyjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To establish the rate of use of various void fillers in the setting of opening\u2010wedge osteotomy around the knee, the types of fixation used, and the rates of delayed union or nonunion related to these variables. In addition, this review addressed short\u2010term to midterm outcomes and complication rates associated with such procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The electronic databases Medline, Embase, and PubMed were searched using the methodology for systematic review as recommended by the Cochrane Collaboration. The search terms used were as follows: knee, osteotomy, knee joint, bone grafting, opening osteotomy, opening wedge, tibial osteotomy, femoral osteotomy, and bone substitute. We screened 1,383 articles and applied exclusion criteria. Fifty\u2010six articles were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 3,033 cases of osteotomy in 2,910 patients. The mean age of patients was 50 years, with a mean follow\u2010up period of 42 months. Male patients comprised 52% of patients. The mean alignment change was 10.8\u00b0, shifting the mechanical axis to 5.1\u00b0 valgus. Delayed union\/nonunion rates were 2.6%, 4.6%, and 4.5% for autograft, allograft bone, and synthetic bone substitutes, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .03). Delayed union\/nonunion rates were significantly lower for autograft compared with allograft (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.03) and for autograft and allograft compared with synthetic bone substitutes (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001). Non\u2010locking plates (n\u00a0=\u00a02,148) had a rate of delayed union\/nonunion of 3.7% and a mean loss of correction over time of 0.5\u00b0. Locking plates (n\u00a0= 681) had a rate of delayed union\/nonunion of 2.6% and a loss of correction of 2.3\u00b0. All mean knee outcome scores improved, and an overall complication rate of 14% was found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Opening\u2010wedge osteotomy had good short\u2010term to midterm outcomes with acceptable complication rates. The lowest rates of delayed union\/nonunion were in autograft bone\u2013filled osteotomies. Plate type does not appear to affect osteotomy union or loss of correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of Level I to IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2014.09.011","type":"journal-article","created":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T05:43:10Z","timestamp":1421214190000},"page":"720-730","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":97,"title":["Bone Grafts and Bone Substitutes for Opening\u2010Wedge Osteotomies of the Knee: A\u00a0Systematic Review"],"prefix":"10.1002","volume":"31","author":[{"given":"Nicholas J.","family":"Lash","sequence":"first","affiliation":[{"name":"OrthoSport Victoria Research Unit Deakin University, and Epworth Healthcare Melbourne 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