Electronic Thesis and Dissertation Repository


Master of Science




Dr. Trevor Birmingham


We investigated the clinical and cost-effectiveness of using a locking versus non-locking fixation plate in medial opening wedge high tibial osteotomy (HTO) for patients with medial compartment knee osteoarthritis. Medical charts were retrospectively reviewed up to 12 months following HTO for 144 patients who received a locking plate and 105 patients who received a non-locking plate. Surgeon notes provided the time to return to full weight- bearing. Participants had completed the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively, six and 12 months postoperatively. Hospital and provincial administrative databases provided direct and indirect cost data. Improvements in KOOS scores were similar between groups. The locking plate was more expensive and therefore its use was not cost-effective from the healthcare payer perspective. However, the locking plate enabled statistically shorter time to return to full weight-bearing, translating to a faster return to work, and therefore its use was cost-effective from the societal perspective.

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