Corrective osteotomies of femur and tibia: which factors influence bone healing?
Introduction Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing. Ma...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2020-03, Vol.140 (3), p.303-311 |
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| description | Introduction
Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing.
Material and methods
The healing process of 547 patients who underwent osteotomies of the lower limb (259 female, 288 male; average 40.6 years, range 14–77) was evaluated. To assess bone healing, participants were divided into three groups by bone healing duration ( 8 months). Differences in healing duration related to the anatomic level of the osteotomy (diaphysis vs. metaphysis), age, gender, smoking status, BMI, and modus of the osteotomy (open vs. closed wedge) were tested for significance using an ordinal regression analysis.
Results
A significant correlation between bone healing and the anatomical level of the osteotomy on femur and tibia and the patients’ smoking status was found. The odds of the diaphysis considering bone healing was 0.187 (95% CI, 0.08–0.44) times that of the metaphysis (Wald
χ
2
(1) = 14.597,
p
|
| doi_str_mv | 10.1007/s00402-019-03217-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_proquest_miscellaneous_2259896098</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2259113005</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-66dc528bfae6989c45e737cae6c3276b0455594b86186fe166a41378a53822b23</originalsourceid><addsrcrecordid>eNqNkE1rFTEUhoMo9lr9Ay4k4EaQ0ZPPybgpMvgFBV3oesjknulNmUlqkrH4703v1AouxFUSeN435zyEPGXwigG0rzOABN4A6xoQnLWNvEd2TArZiI7p-2QHndCNAcVOyKOcLwEYNx08JCeCCdYK4DvypY8poSv-B9KYC8YSF4-ZxolOuKyJ2rCnxY_evqHXB-8OdLKuxJSpD9O8YnBIxxiQHtDOPlycPSYPJjtnfHJ7npJv79997T82558_fOrfnjdOtKo0Wu-d4macLOrOdE4qbEXr6ssJ3uoRpFKqk6PRzOgJmdZWMtEaq4ThfOTilLzYeq9S_L5iLsPis8N5tgHjmgfOVe3V0JmKPv8LvYxrCnW6I8WYAFCV4hvlUsw54TRcJb_Y9HNgMNz4HjbfQ_U9HH0Psoae3Vav44L7u8hvwRV4uQHXOMYpO39j7A6D-jGTXct0vR1p8_9074stPoY-rqHUqNiiueLhAtOfJf8x_y9WFamp</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2259113005</pqid></control><display><type>article</type><title>Corrective osteotomies of femur and tibia: which factors influence bone healing?</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Simon, Michael H. ; Grünwald, L. ; Schenke, M. ; Dickschas, J. ; Strecker, W.</creator><creatorcontrib>Simon, Michael H. ; Grünwald, L. ; Schenke, M. ; Dickschas, J. ; Strecker, W.</creatorcontrib><description>Introduction
Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing.
Material and methods
The healing process of 547 patients who underwent osteotomies of the lower limb (259 female, 288 male; average 40.6 years, range 14–77) was evaluated. To assess bone healing, participants were divided into three groups by bone healing duration ( < 5/5–8/ > 8 months). Differences in healing duration related to the anatomic level of the osteotomy (diaphysis vs. metaphysis), age, gender, smoking status, BMI, and modus of the osteotomy (open vs. closed wedge) were tested for significance using an ordinal regression analysis.
Results
A significant correlation between bone healing and the anatomical level of the osteotomy on femur and tibia and the patients’ smoking status was found. The odds of the diaphysis considering bone healing was 0.187 (95% CI, 0.08–0.44) times that of the metaphysis (Wald
χ
2
(1) = 14.597,
p
< 0.000). The odds ratio of smokers considering bone healing was 0.192 (95% CI, 0.11–0.33) times that of non-smokers (Wald
χ
2
(1) = 35.420,
p
< 0.000). All other analyzed factors did not show a significant correlation with bone healing.
Conclusions
Smoking status and the localization of the osteotomy on femur and tibia (diaphysis vs. metaphysis) are significantly correlated with bone healing duration. In line with current literature emphasizing the detrimental effect of smoking on bone healing, our findings should encourage surgeons to think twice about the indication to perform osteotomies on smokers. Furthermore, if applicable, osteotomies should be performed in the metaphyseal areas of femur and tibia.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-019-03217-4</identifier><identifier>PMID: 31317302</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Arthritis ; Bone surgery ; Bones ; Congenital diseases ; Female ; Femur - physiology ; Femur - surgery ; Humans ; Joint surgery ; Life Sciences & Biomedicine ; Localization ; Male ; Medicine ; Medicine & Public Health ; Metabolic disorders ; Middle Aged ; Orthopaedic Surgery ; Orthopedics ; Osteotomy - methods ; Osteotomy - statistics & numerical data ; Patients ; Prospective Studies ; Science & Technology ; Smoking ; Surgeons ; Surgery ; Surgical techniques ; Tibia - physiology ; Tibia - surgery ; Trauma ; Wound Healing - physiology ; X-rays ; Young Adult</subject><ispartof>Archives of orthopaedic and trauma surgery, 2020-03, Vol.140 (3), p.303-311</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>13</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000514971600002</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c375t-66dc528bfae6989c45e737cae6c3276b0455594b86186fe166a41378a53822b23</citedby><cites>FETCH-LOGICAL-c375t-66dc528bfae6989c45e737cae6c3276b0455594b86186fe166a41378a53822b23</cites><orcidid>0000-0002-7525-596X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-019-03217-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-019-03217-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27933,27934,28257,41497,42566,51328</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31317302$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Simon, Michael H.</creatorcontrib><creatorcontrib>Grünwald, L.</creatorcontrib><creatorcontrib>Schenke, M.</creatorcontrib><creatorcontrib>Dickschas, J.</creatorcontrib><creatorcontrib>Strecker, W.</creatorcontrib><title>Corrective osteotomies of femur and tibia: which factors influence bone healing?</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>ARCH ORTHOP TRAUM SU</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing.
Material and methods
The healing process of 547 patients who underwent osteotomies of the lower limb (259 female, 288 male; average 40.6 years, range 14–77) was evaluated. To assess bone healing, participants were divided into three groups by bone healing duration ( < 5/5–8/ > 8 months). Differences in healing duration related to the anatomic level of the osteotomy (diaphysis vs. metaphysis), age, gender, smoking status, BMI, and modus of the osteotomy (open vs. closed wedge) were tested for significance using an ordinal regression analysis.
Results
A significant correlation between bone healing and the anatomical level of the osteotomy on femur and tibia and the patients’ smoking status was found. The odds of the diaphysis considering bone healing was 0.187 (95% CI, 0.08–0.44) times that of the metaphysis (Wald
χ
2
(1) = 14.597,
p
< 0.000). The odds ratio of smokers considering bone healing was 0.192 (95% CI, 0.11–0.33) times that of non-smokers (Wald
χ
2
(1) = 35.420,
p
< 0.000). All other analyzed factors did not show a significant correlation with bone healing.
Conclusions
Smoking status and the localization of the osteotomy on femur and tibia (diaphysis vs. metaphysis) are significantly correlated with bone healing duration. In line with current literature emphasizing the detrimental effect of smoking on bone healing, our findings should encourage surgeons to think twice about the indication to perform osteotomies on smokers. Furthermore, if applicable, osteotomies should be performed in the metaphyseal areas of femur and tibia.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Arthritis</subject><subject>Bone surgery</subject><subject>Bones</subject><subject>Congenital diseases</subject><subject>Female</subject><subject>Femur - physiology</subject><subject>Femur - surgery</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Life Sciences & Biomedicine</subject><subject>Localization</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic disorders</subject><subject>Middle Aged</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>Osteotomy - methods</subject><subject>Osteotomy - statistics & numerical data</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Science & Technology</subject><subject>Smoking</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical techniques</subject><subject>Tibia - physiology</subject><subject>Tibia - surgery</subject><subject>Trauma</subject><subject>Wound Healing - physiology</subject><subject>X-rays</subject><subject>Young Adult</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkE1rFTEUhoMo9lr9Ay4k4EaQ0ZPPybgpMvgFBV3oesjknulNmUlqkrH4703v1AouxFUSeN435zyEPGXwigG0rzOABN4A6xoQnLWNvEd2TArZiI7p-2QHndCNAcVOyKOcLwEYNx08JCeCCdYK4DvypY8poSv-B9KYC8YSF4-ZxolOuKyJ2rCnxY_evqHXB-8OdLKuxJSpD9O8YnBIxxiQHtDOPlycPSYPJjtnfHJ7npJv79997T82558_fOrfnjdOtKo0Wu-d4macLOrOdE4qbEXr6ssJ3uoRpFKqk6PRzOgJmdZWMtEaq4ThfOTilLzYeq9S_L5iLsPis8N5tgHjmgfOVe3V0JmKPv8LvYxrCnW6I8WYAFCV4hvlUsw54TRcJb_Y9HNgMNz4HjbfQ_U9HH0Psoae3Vav44L7u8hvwRV4uQHXOMYpO39j7A6D-jGTXct0vR1p8_9074stPoY-rqHUqNiiueLhAtOfJf8x_y9WFamp</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Simon, Michael H.</creator><creator>Grünwald, L.</creator><creator>Schenke, M.</creator><creator>Dickschas, J.</creator><creator>Strecker, W.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7525-596X</orcidid></search><sort><creationdate>20200301</creationdate><title>Corrective osteotomies of femur and tibia: which factors influence bone healing?</title><author>Simon, Michael H. ; Grünwald, L. ; Schenke, M. ; Dickschas, J. ; Strecker, W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-66dc528bfae6989c45e737cae6c3276b0455594b86186fe166a41378a53822b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Arthritis</topic><topic>Bone surgery</topic><topic>Bones</topic><topic>Congenital diseases</topic><topic>Female</topic><topic>Femur - physiology</topic><topic>Femur - surgery</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Life Sciences & Biomedicine</topic><topic>Localization</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic disorders</topic><topic>Middle Aged</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Osteotomy - methods</topic><topic>Osteotomy - statistics & numerical data</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Science & Technology</topic><topic>Smoking</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical techniques</topic><topic>Tibia - physiology</topic><topic>Tibia - surgery</topic><topic>Trauma</topic><topic>Wound Healing - physiology</topic><topic>X-rays</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Simon, Michael H.</creatorcontrib><creatorcontrib>Grünwald, L.</creatorcontrib><creatorcontrib>Schenke, M.</creatorcontrib><creatorcontrib>Dickschas, J.</creatorcontrib><creatorcontrib>Strecker, W.</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Simon, Michael H.</au><au>Grünwald, L.</au><au>Schenke, M.</au><au>Dickschas, J.</au><au>Strecker, W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Corrective osteotomies of femur and tibia: which factors influence bone healing?</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><stitle>ARCH ORTHOP TRAUM SU</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>140</volume><issue>3</issue><spage>303</spage><epage>311</epage><pages>303-311</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing.
Material and methods
The healing process of 547 patients who underwent osteotomies of the lower limb (259 female, 288 male; average 40.6 years, range 14–77) was evaluated. To assess bone healing, participants were divided into three groups by bone healing duration ( < 5/5–8/ > 8 months). Differences in healing duration related to the anatomic level of the osteotomy (diaphysis vs. metaphysis), age, gender, smoking status, BMI, and modus of the osteotomy (open vs. closed wedge) were tested for significance using an ordinal regression analysis.
Results
A significant correlation between bone healing and the anatomical level of the osteotomy on femur and tibia and the patients’ smoking status was found. The odds of the diaphysis considering bone healing was 0.187 (95% CI, 0.08–0.44) times that of the metaphysis (Wald
χ
2
(1) = 14.597,
p
< 0.000). The odds ratio of smokers considering bone healing was 0.192 (95% CI, 0.11–0.33) times that of non-smokers (Wald
χ
2
(1) = 35.420,
p
< 0.000). All other analyzed factors did not show a significant correlation with bone healing.
Conclusions
Smoking status and the localization of the osteotomy on femur and tibia (diaphysis vs. metaphysis) are significantly correlated with bone healing duration. In line with current literature emphasizing the detrimental effect of smoking on bone healing, our findings should encourage surgeons to think twice about the indication to perform osteotomies on smokers. Furthermore, if applicable, osteotomies should be performed in the metaphyseal areas of femur and tibia.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31317302</pmid><doi>10.1007/s00402-019-03217-4</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7525-596X</orcidid></addata></record> |
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| subjects | Adolescent Adult Age Aged Arthritis Bone surgery Bones Congenital diseases Female Femur - physiology Femur - surgery Humans Joint surgery Life Sciences & Biomedicine Localization Male Medicine Medicine & Public Health Metabolic disorders Middle Aged Orthopaedic Surgery Orthopedics Osteotomy - methods Osteotomy - statistics & numerical data Patients Prospective Studies Science & Technology Smoking Surgeons Surgery Surgical techniques Tibia - physiology Tibia - surgery Trauma Wound Healing - physiology X-rays Young Adult |
| title | Corrective osteotomies of femur and tibia: which factors influence bone healing? |
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