Axial But Not Sagittal Hinge Axis Affects Posterior Tibial Slope in Medial Open-wedge High Tibial Osteotomy: A Three-dimensional Surgical Simulation Study

2021 ◽  
Author(s):  
Yuanjun Teng ◽  
Hideki Mizu-uchi ◽  
Yayi Xia ◽  
Yukio Akasaki ◽  
Takenori Akiyama ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Simulation Study ◽  
Surgical Simulation ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Posterior Tibial ◽  
Wedge High Tibial Osteotomy ◽  
Hinge Axis

Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy

2011 ◽  
Vol 20 (3) ◽  
pp. 571-578 ◽  
Author(s):  
Shigeki Asada ◽  
Masao Akagi ◽  
Shigeshi Mori ◽  
Tetsunao Matsushita ◽  
Kazuki Hashimoto ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Frontal Plane ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Correction Loss ◽  
Posterior Tibial ◽  
Wedge High Tibial Osteotomy

The effects of different hinge positions on posterior tibial slope in medial open-wedge high tibial osteotomy

2017 ◽  
Vol 26 (6) ◽  
pp. 1851-1858 ◽  
Author(s):  
Ho-Seung Jo ◽  
Jin-Sung Park ◽  
June-Ho Byun ◽  
Young-Bok Lee ◽  
Young-Lac Choi ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Posterior Tibial ◽  
Wedge High Tibial Osteotomy

scholarly journals Is it possible to avoid posterior tibial slope increase in open-wedge high tibial osteotomy?

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0005
Author(s):  
Hüseyin Kaya ◽  
Elcil Kayabiçer ◽  
Ali Engin Daştan ◽  
Emin Taşkıran
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Slope ◽  
Statistical Analyses ◽  
Posterior Tibial Slope ◽  
Tibial Osteotomy ◽  
X Rays ◽  
Open Wedge ◽  
P Values ◽  
Posterior Tibial ◽  
Wedge High Tibial Osteotomy

Aim: Posterior tibial slope has shown to be increased with open-wedge high tibial osteotomy (OWHTO) which may lead to an increase in loading of the anterior cruciate ligament and causing patellofemoral problems in return. In this case series, patients with an OWHTO performed posteromedial to the medial collateral ligament (MCL), keeping it intact was investigated. The aim of this study was to evaluate the influence of this technique on the posterior tibial slope. Methods: Thirty knees (15 right, 15 left) of 28 patients (22 women, 6 men) with a mean age of 53.57±5.9 years who had an OWHTO between January 2014 and February 2016 were included in this study. Surgical technique: A proximal tibial osteotomy is performed posteromedial to MCL keeping it intact. Following the osteotomy, distraction is also performed from the posteromedial aspect of tibia. Fixation is achieved utilizing TomoFix plate. Radiological evaluation: Preoperative and postoperative mechanical axes (MA) were measured on standard weight bearing long axis x-rays. Preoperative and postoperative posterior tibial slope angles were measured on lateral x-rays using three different Methods: the angles between medial tibial plateau and (1) posterior tibial cortex, (2) tibial proximal anatomical axis, and (3) posterior fibular cortex were measured. The correlations of three different measurement methods were analyzed. Patients were grouped according to preoperative MA deviations and postoperative MA changes (either <10º or >=10º). The posterior tibial slope changes were compared between groups. Statistical analyses: All statistical analyses were performed utilizing SPSS 18.0. Results: Mean preoperative and postoperative MA deviations were 9.81°±4.94° and -2.72°± 2.69° respectively. The mean correction angle of MA of lower extremity was 12.62°±4.58°. The three methods used to measure the posterior tibial slope angles were found to be highly correlated with each other ((1) and (2) r=0.961; (1) and (3) 0.906; (2) and (3) 0.934; p values <0.0001). Preoperative mean posterior tibial slope angles were 9.50º±4.47°, 11.51º± 4.50°, and 10.80º±4.58°; postoperative angles were 6.10º±4.23°, 8.78º±4.57° and 8.11º±4.55°, respectively. Posterior tibial slope angle was significantly decreased postoperatively with respect to all three methods (p <0.0001). The changes in the posterior tibial slope was not statistically significant between the groups with preoperative <10º and >=10º deformities (p values 0.861, 0.723, 0.727, respectively). Conclusions: Posterior tibial slope was found to be decreased with this posteromedial OWHTO technique. This technique offered the advantage of preserving the posterior tibial slopes postoperatively even in highly deformed knees which necessitated higher degrees of corrections in the mechanical axes.

scholarly journals Effect of Computer Navigation on Accuracy and Reliability of Limb Alignment Correction following Open-Wedge High Tibial Osteotomy: A Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Seung-Beom Han ◽  
Hyun Jung Kim ◽  
Dae-Hee Lee
Keyword(s):  
High Tibial Osteotomy ◽  
Meta Analysis ◽  
Computer Navigation ◽  
Tibial Slope ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Limb Alignment ◽  
Posterior Tibial ◽  
Alignment Correction ◽  
Wedge High Tibial Osteotomy

Background. It is unclear whether computer navigation can improve the accuracy and reliability of targeted lower limb alignment correction following open-wedge high tibial osteotomy (HTO). This meta-analysis was designed to compare the accuracy and reliability of limb alignment correction between computer navigated and conventional open-wedge HTOs. Methods. Studies that compared postoperative coronal alignment, including mechanical axis (MA) and weight bearing line (WBL) ratio, outliers of alignment correction, and change in tibial posterior slope, following open-wedge HTO performed using computer navigated and conventional methods were included. Results. Ten studies were included in the meta-analysis. The MA (0.93°; 95% confidence interval [CI]: 0.45–1.41°; P<0.001) and WBL ratio (1.5%; 95% CI: 0.03–2.98%; P=0.048) were significantly greater for computer navigated HTO than for conventional HTO. Outliers of alignment correction after surgery were significantly lower in patients who underwent computer navigated HTO than in those who underwent conventional HTO (odds ratio: 0.25; 95% CI: 0.08–0.79; P=0.02). Changes in posterior tibial slope from before to after surgery, however, were similar for the two approaches. Conclusion. Computer navigated HTO resulted in slightly more valgus postoperative alignment and effectively reduced outliers of alignment correction but had no effect on change in posterior tibial slope when compared with conventional HTO.

Sign in / Sign up

Export Citation Format

Share Document