scholarly journals Arthroscopy-Assisted Computer Navigation in High Tibial Osteotomy for Varus Knee Deformity

2009 ◽  
Vol 17 (1) ◽  
pp. 51-55 ◽  
Author(s):  
WN Lo ◽  
KW Cheung ◽  
SH Yung ◽  
KH Chiu
Keyword(s):  
High Tibial Osteotomy ◽  
Computer Navigation ◽  
Mean Deviation ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Varus Knee ◽  
Knee Alignment ◽  
Knee Deformity ◽  
The Mean ◽  
Open Wedge Hto

Purpose. To assess the accuracy of knee alignment after high tibial osteotomy (HTO) for varus knee deformity using arthroscopy-assisted computer navigation. Methods. Six men and 4 women aged 47 to 53 (mean, 49) years underwent medial open wedge HTO for varus knee deformity and medial unicompartmental osteoarthritis using arthroscopy-assisted computer navigation with fluoroscopy. Patients were followed up for a mean of 23 (range, 11–32) months. Intra- and post-operative leg alignments were compared. Results. The mean postoperative coronal plane alignment was 2.7 (range, 1–4) degree valgus; the mean deviation from intra-operative computer images was one (range, 0.1–1.9) degree; 5 knees had less valgus in the postoperative radiographs than the intra-operative computer images. Conclusion. Despite being more technically demanding, time consuming, and costly, arthroscopy-assisted computer navigation is safe, accurate, and reliable for HTO.

Open-wedge high tibial osteotomy in patients with discoid lateral meniscus

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110173
Author(s):  
Hee-June Kim ◽  
Ji-Yeon Shin ◽  
Hyun-Joo Lee ◽  
Chul-Hee Jung ◽  
Kyeong-Hyeon Park ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Lateral Meniscus ◽  
Lateral Compartment ◽  
Clinical Results ◽  
Discoid Lateral Meniscus ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Factors Affecting ◽  
The Mean ◽  
Open Wedge Hto

Background: There are concerns about the progression of the lateral osteoarthritis (OA) should be taken into account when high tibial osteotomy (HTO) is performed in patients with discoid lateral meniscus (LM). This study evaluated the clinical results of HTO in patients with discoid LM and elucidated factors affecting the results. Methods: This study evaluated 32 female patients with varus deformity and medial OA. Patients with discoid LM (8 patients) or without discoid LM (24 patients) underwent open-wedge HTO. The mean age was 53.5 years and the mean follow-up period was 35 months. Clinical results, including the Hospital for Special Surgery (HSS) score, Knee Society knee score (KS) and function score (FS), were evaluated. The progression of OA in the lateral compartment was also evaluated. Finally, we evaluated the factors affecting the clinical results and OA progression in the lateral compartment. Results: Between two groups, all clinical scores were not different (p = 0.964, 0.963, and 0.559, respectively). Three of eight patients (37.5%) in the discoid group developed OA in the lateral compartment, whereas 2 of 24 patients (8.3%) in the control group developed such; however, this was not significantly different (p = 0.085). In discoid group, patients with undercorrection has higher KS relative to patients with acceptable correction (p = 0.044). Other clinical results and OA change in the lateral compartment were not affected by evaluated factors. Conclusions: Patients who underwent open-wedge HTO showed the satisfactory clinical results and lateral OA progression regardless of the presence or absence discoid LM. However, when discoid LM was present, patients with undercorrection showed higher KS in comparison with patients with acceptable correction.

scholarly journals Use of 4.5 Non-locking Plate As an Alternative Device in Open Wedge High Tibial Osteotomy for Treating Varus Deformity

2020 ◽  
Vol 7 (2) ◽  
pp. 55-60
Author(s):  
Mahmood Jabalameli ◽  
◽  
Sepehr Khosravi ◽  
Delaram Delbari ◽  
Abolfazl Bagheri Fard ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Locking Plate ◽  
Varus Deformity ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Varus Knee ◽  
Knee Deformity ◽  
Wedge High Tibial Osteotomy ◽  
Buttress Plate

Background: High Tibial Osteotomy (HTO) is an approved surgical technique for varus knee deformity. For open wedge HTO multiple fixation methods and devices have been used. Advantages and disadvantages of these methods and devices are reported in various studies. Few studies have been conducted on use and final outcome of correction of varus knee deformity by implementation of non locking plates and benefits of this method is not fully evaluated. Objectives: To assess clinical and radiographic features of non-locking 4.5 millimeter L-buttress plate and T-buttress plate, which is used in open wedge High Tibial Osteotomy (HTO), and to find out whether this device is efficient enough or not. Methods: This cross-sectional study was conducted on 39 patients with tibial deformity recruited from a referral orthopedic hospital in Iran. Patients’ information, including their baseline characteristics, Range of Motion (ROM) of the knee, comorbidities, time of weight-bearing, union time in x-ray, graft type, and time of follow-up were reported at two stages: before and after the operation. Radiographic images were taken from their legs in both stages. Although different surgeons operated on the cases, they all used the same method. After the surgery, they were checked up in 2, 6, 12, and 24 weeks and a second alignment view was taken from the patients. Results: Thirty-nine patients underwent surgery for the correction of genu varus deformity and the follow-up time was between 6-48 months. There was no case of non-union and the ROM was perfectly restored in all the patients. Conclusion: Although the rate of the success in the use of the locking plate in HTO is higher, the use of a 4.5-mm non-locking plate seems to have decent results, too; therefore, it could be used as an alternative yet functional fixation tool in HTO.

Evaluation of Accuracy of a Three-Dimensional Printed Model in Open-Wedge High Tibial Osteotomy

2018 ◽  
Vol 32 (09) ◽  
pp. 841-846 ◽  
Author(s):  
Hee-June Kim ◽  
Jaeyeong Park ◽  
Kyeong-Hyeon Park ◽  
Il-Hyung Park ◽  
Jin-An Jang ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Target Angle ◽  
Wedge High Tibial Osteotomy ◽  
3D Printed ◽  
The Mean ◽  
Open Wedge Hto

AbstractThe purpose of this study was to evaluate the usefulness of a three-dimensional (3D) printed model for open-wedge high tibial osteotomy (HTO). This study retrospectively evaluated 20 patients with medial knee osteoarthritis and varus deformity. Between October 2015 and July 2016, the patients underwent open-wedge HTO using a 3D printed model. The mean age of patients was 55.2 years (range, 51–60 years). The mean preoperative mechanical femorotibial angle (mFTA) was varus 7.8 degrees (range, varus 4.7–11.6 degrees). After measuring the target angle using full-length lower limb weight-bearing radiography, the osteotomy was simulated using 3D images obtained from computed tomography (CT) with the 3D Slicer program. On the basis of the simulated osteotomy section and the target angle, the model was then designed and printed. Open-wedge HTO was then performed by applying the 3D printed model to the opening gap. The accuracy of osteotomy and the change in posterior tibial slope (PTS) angle were evaluated. The weight-bearing line on the tibial plateau was corrected from a preoperative mean of 19.5 ± 9.8% to a postoperative mean of 63.1 ± 6.1% (p < 0.001). The postoperative values were not statistically significantly different from the preoperative target points (p = 0.688). The mFTA was corrected to a postoperative mean of valgus 3.8 ± 1.4 degrees. The PTS angle showed no significant change (p = 0.256). A 3D printed model using CT may be useful for preoperative planning of open-wedge HTO. Satisfactory correction can be obtained without a change in the PTS.

scholarly journals Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee

2009 ◽  
Vol 10 (9) ◽  
pp. 689-695 ◽  
Author(s):  
Hai-ning Zhang ◽  
Jie Zhang ◽  
Cheng-yu Lv ◽  
Ping Leng ◽  
Ying-zhen Wang ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Locking Plate ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Varus Knee ◽  
Wedge High Tibial Osteotomy

scholarly journals Total Knee Arthroplasty Conversion after Open-wedge High Tibial Osteotomy

2021 ◽  
Vol 15 (1) ◽  
pp. 53-56
Author(s):  
Wataru Kusano ◽  
Takatomo Mine ◽  
Koichiro Ihara ◽  
Yasuhiro Tominaga ◽  
Hiroyuki Kawamura ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Soft Tissue Release ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Term Survival ◽  
Wedge High Tibial Osteotomy ◽  
Total Knee ◽  
Open Wedge Hto

Background: Open-wedge High Tibial Osteotomy (HTO) is an effective treatment for Osteoarthritis (OA) of the knee; however, postoperative changes due to HTO can make subsequent Total Knee Arthroplasty (TKA) technically difficult and can affect long-term survival. Case Report: Medio-lateral stability along with balanced flexion and extension gaps provides a good functional outcome. A 71-year-old man underwent TKA conversion after open-wedge HTO 12 years earlier; the conversion was performed due to arthritic deterioration in the knee. Medial instability was noted because of poor ligament balancing. The residual medial instability was managed with a knee brace due to the unavailability of the constrained prosthesis. Management of persistent mediolateral instability persisting after soft tissue release and balancing ideally requires varus-valgus constraint. Conclusion: TKA conversion after open-wedge HTO requires a special technique and careful preparation before surgery.

scholarly journals The difficulty of continuing sports activities after open-wedge high tibial osteotomy in patient with medial knee osteoarthritis: a retrospective case series at 2-year-minimum follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Shugo Maeda ◽  
Daisuke Chiba ◽  
Eiji Sasaki ◽  
Tetsushi Oyama ◽  
Tomoyuki Sasaki ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Case Series ◽  
Tibial Osteotomy ◽  
Activity Levels ◽  
Open Wedge ◽  
Retrospective Case ◽  
Sports Activity ◽  
Wedge High Tibial Osteotomy ◽  
The Mean

Abstract Purpose This study aimed to investigate the rate at which patients returned to sports after open wedge high tibial osteotomy and identify the continuity of sports activity post-operatively. Methods Thirty-five patients (40 knees) who underwent open-wedge high tibial osteotomy (OW-HTO) in medial knee osteoarthritis were included in this study. The mean age of the patients who underwent surgery was 55.1 ± 10.7 years, and the mean follow-up period was 41.0 ± 24.7 months. Clinical results and radiographic parameters calculated in standing whole-leg radiographs preoperatively, post-operatively, and at the final follow-up were evaluated. Results Thirty-one patients (88.6%) were able to return to preoperative sports activity; however, only 14 patients (40.0%) completely returned to preoperative sports activity levels. Of the 31 patients who returned to sports activity, 10 patients (32.3%) maintained post-operative sporting activity levels at the final follow-up. In radiographic parameters, the weight-bearing line ratio was considered loss of correction in the post-operative period leading to the final follow-up. Patients who completely returned to sports and maintained sporting activity levels at the final follow-up had significantly higher the Knee Injury and Osteoarthritis Outcome Score pain subscale values and lower visual analogue scale of knee pain at pre-surgery and final follow-up than other patients, including those who partially returned to sports. Conclusions The proportion of patients who returned to sports after OW-HTO and were able to participate in competitions at the same activity level as before surgery was low and insufficient. Level of evidence Retrospective case series, IV

Ankle and Hindfoot Symptoms after Medial Open Wedge High Tibial Osteotomy

2018 ◽  
Vol 32 (03) ◽  
pp. 269-273 ◽  
Author(s):  
Jason Roberts ◽  
Frederic Picard ◽  
Siddharth Shah
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Postoperative Change ◽  
Radiological Indices ◽  
Wedge High Tibial Osteotomy ◽  
The Mean ◽  
New Onset

AbstractMedial open wedge high tibial osteotomy (MOWHTO) is a commonly performed procedure for symptomatic medial compartment osteoarthritis (OA). However, little is known about its effects on ipsilateral ankle or hindfoot. The aim of our study was to determine the incidence of ankle or hindfoot problems after MOWHTO and examine its association with radiological indices. Thirty-five knees (32 patients) undergoing navigated MOWHTO were evaluated for the presence of new-onset ankle or hindfoot symptoms after surgery. Pre- and postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and tibial plafond inclination (TPI) were measured and compared on standing lower limb alignment radiographs. The mean postoperative change in HKA angle, MPTA, and TPI was 8.8°, 7.0°, and 8.4°, respectively. New-onset unexplained ankle or hindfoot symptoms were seen in 20% of the cases after surgery. Postoperative change in TPI was significantly greater in symptomatic patients as compared with asymptomatic ones (12.8° ± 4.9° vs. 8.1° ± 4.8°, p = 0.03). The odds ratio (OR) for developing ankle or hindfoot symptoms in cases with ≥ 10° change in TPI postoperatively was 10.8 (p = 0.04). Ankle or hindfoot symptoms were successfully managed with conservative treatment in all cases.

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.

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