Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy

Marti, Christoph B.; Gautier, Emanuel; Wachtl, S. W.; Jakob, R. P.

doi:10.1016/j.arthro.2004.01.024

Cited by 300 publications

(290 citation statements)

References 14 publications

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“…Until 1965, osteotomy was popularized by Coventry (1965), who modified the procedures by executing the osteotomy proximal to the tibial tubercle. The advantages of the modified surgery were that the cancellous bone could heal rapidly, and early weight-bearing on the leg could be ensured by the tensile strength of the quadriceps, which could stabilize the osteotomy (Marti et al, 2004). Retrospectively, long-time studies had documented the efficacy of HTO, indication, planning, and techniques, and reported that it could delay the necessity of a knee arthroplasty often by more than 10 years.…”

Section: Discussionmentioning

confidence: 99%

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

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To introduce and characterize the modified biplanar opening high tibial osteotomy with rigid fixation to treat varus knee in young and active patients. Methods: Between June 2001 to July 2008, 18 patients with monocompartmental degeneration of the knee combined with a varus malalignment of the leg had the modified biplanar opening high tibial osteotomy and the osteotomy was fixed with the locking plates (Locking Compression Plate System). The mean varus deformity before operation was 11.5° (5°~19°) and no degenerative changes were found in other departments. Stability of the knee was normal in 15 patients, but ruptures in anterior cruciate ligaments or lateral collateral ligament were presented in the remaining 3 patients. Preoperative symptom was mainly limited in the pain of medial compartment. The preoperative and follow-up data for the range of motion and Lysholm score were determined. Subjective satisfactory examination was also applied to the patients for the operation they selected. Results: All of the patients were followed up with an average of 32.5 months (12~82 months). There was no ununion or delayed union in this group during the follow-up period. No complications like broken plate, nerve injury, or blood vessel injury occurred. The postoperative average corrected degree was 9.5° (5.5°~18°). No degenerations developed in the three departments of the knee. The Lysholm scores before and after surgery were 42.5 and 77.5, respectively (P<0.01). The overall fineness rate was 83.3%. The subjective satisfactory survey demonstrated that about 83.3% patients showed satisfactory on the operation. There was no obvious difference in the range of motion before and after operation, but significant changes were found in the Lysholm score and varus degree from preoperative to follow-up. Conclusion: Proximal opening high tibial osteotomy performed in conjunction with the special rigid locking plate yielded good results for symptomatic genu varum. This new classic technique can be effectively applied to the medial compartment degeneration of the knee in active young patients.

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Section: Discussionmentioning

confidence: 99%

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

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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“…Our study showed that this fixatorassisted technique achieved accurate target correction in the coronal plane while maintaining posterior tibial slope in the sagittal plane. Conventional opening-wedge high tibial osteotomy has several technical pitfalls that can result in increased posterior tibial slope, internal torsion of the tibia, etc [14,15,24]. Although the tibial slope is important in knee kinematics and proper function of the knee ligaments, maintaining constant tibial slope after opening-wedge high tibial osteotomy still remains an unsolved problems [1,11,24,27].…”

Section: Discussionmentioning

confidence: 99%

“…Conventional opening-wedge high tibial osteotomy has several technical pitfalls that can result in increased posterior tibial slope, internal torsion of the tibia, etc [14,15,24]. Although the tibial slope is important in knee kinematics and proper function of the knee ligaments, maintaining constant tibial slope after opening-wedge high tibial osteotomy still remains an unsolved problems [1,11,24,27]. Several surgical methods were recommended to avoid an increase in posterior tibial slope in conventional opening-wedge high tibial osteotomy: sufficient release of posterior soft tissues, complete osteotomy of the posterior tibial cortex, avoidance of an intact cortical hinge on the posterolateral side, and full extended position of the knee during fixation with plating, all of which showed limitations [5,27,29].…”

Section: Discussionmentioning

confidence: 99%

Fixator-assisted Technique Enables Less Invasive Plate Osteosynthesis in Medial Opening-wedge High Tibial Osteotomy: A Novel Technique

Lee

Ryu

Kim

et al. 2015

Clin Orthop Relat Res

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Background Opening-wedge high tibial osteotomy is a well-established procedure in the management of medial osteoarthritis of the knee and correction of proximal tibia vara. Recently, surgical approaches using less invasive plate osteosynthesis have been used with the goal of minimizing complications from more extensive soft tissue exposures. However, to our knowledge, less invasive fixator-assisted plate osteosynthesis has not been tested in the setting of opening-wedge high tibial osteotomy.

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“…Osteotomy should not be performed below tibial anterior tuberosity, because this technique increases the risk of pseudoarthrosis (10) . Concerning deformity correction, literature has demonstrated a good genuvarus correction, i.e., a postoperative mechanical axis between 3 and 6 degrees of valgus with the use of other plates (4,(11)(12)(13) . Our study achieved a mean final mechanical axis of 3.4 degrees of valgus (13) .…”

Section: Discussionmentioning

confidence: 99%

Consolidação da osteotomia valgizante proximal da tíbia com cunha de abertura fixada com placa "calço" de Anthony®

et al. 2008

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OBJETIVO: Este estudo tem por finalidade verificar a consolidação da osteotomia valgizante da tíbia com cunha de abertura fixada com placa tipo calço de Anthony® (OVT), no tratamento da osteoartrose medial do joelho varo, a correção da deformidade e a resposta clínica ao tratamento cirúrgico. MÉTODOS: Vinte pacientes (vinte joelhos) com osteoartrose do compartimento medial do joelho, com idade média de 48,4 ± 9,9, foram avaliados por um período mínimo de um ano. Os pacientes foram submetidos a avaliação radiográfica da consolidação e do eixo mecânico no pré e pós operatório, além da avaliação dos critérios de LYSHOLM. RESULTADOS: A consolidação da osteotomia ocorreu após 12 semanas em 100% dos casos sem complicações. A avaliação do LYSHOLM no pós operatório apresentou 80% de excelentes e bons resultados. A correção final média do eixo mecânico foi de 3,4 ± 3,3 graus de valgo. CONCLUSÃO: Concluímos que a consolidação da osteotomia supra-tuberositária da tíbia com cunha de abertura fixada com placa calço de Anthony® e com enxertia óssea tricortical ocorre num intervalo de três meses. A cirurgia é eficaz para a correção da deformidade em varo do joelho, e propicia melhora clínica significante para o paciente.

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Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy

Cited by 300 publications

References 14 publications

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

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

Fixator-assisted Technique Enables Less Invasive Plate Osteosynthesis in Medial Opening-wedge High Tibial Osteotomy: A Novel Technique

Consolidação da osteotomia valgizante proximal da tíbia com cunha de abertura fixada com placa "calço" de Anthony®

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