Clinical efficacy of preoperative 3D planning for reducing surgical errors during open-wedge high tibial osteotomy

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
Shinichi KuriyamaHidehiko Higaki

Abstract

Increases in posterior tibial slope (PTS) with open-wedge high tibial osteotomy (OWHTO) are often related to two surgical errors: Symmetric opening of the osteotomy gap and a tendency to open the gap from the anteromedial direction. The study objective was to define trends in these two errors using computer simulation and clinical effects of their countermeasures. First, 60 knees with varus deformity were assessed with three-dimensional (3D) planning using computed tomography to allow for the mechanical axis to pass through a point at 62.5% of the width of the tibial plateau, defined as the weight-bearing line percentage (WBL%). Anterior and posterior widths of the opening gap to maintain PTS were measured. The effect on PTS when osteotomy gaps were opened from the anteromedial direction up to 30° was evaluated. Mean anterior width (y) was 6.6 mm (range, 2.2-10.9) and mean posterior width (x) was 9.1 mm (range, 3.9-15.7), which can be expressed as y = 0.75x - 0.24. Opening gaps from the anteromedial direction at 10°, 20°, and 30° led to a mean PTS increase of 1.9°, 3.9°, and 5.6°, respectively. In most cases, WBL% with anteromedial opening at 30° passed through a point at less than 60%. In 47 knees that underwent OWHTO using 3D...Continue Reading

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Citations

Sep 11, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·S CercielloR Seil
Jun 23, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Shinichi KuriyamaShuichi Matsuda
Feb 14, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Yuanjun TengYasuharu Nakashima
Mar 3, 2021·Knee Surgery & Related Research·Takehiko MatsushitaRyosuke Kuroda
Dec 29, 2020·Strategies in Trauma and Limb Reconstruction·L N SolominP N Kulesh

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