Changes in osseous correction after proximal tibial osteotomy: Radiostereometry of closed- and open-wedge osteotomy in 33 patients

Magyar, G.; Lindstrand, Anders

doi:10.3109/17453679909000983

Cited by 45 publications

(46 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pape et al (2004) detected no loss of valgus correction on full weight-bearing standing radiographs in patients with a fractured medial cortex of the proximal tibia after a closing-wedge procedure either; they used an L-shaped rigid plate, which is supposed to offer high primary stability. Radiostereometric findings indicate a less stable situation for closing-wedge osteotomy when bone staples with a plaster cast are used (Magyar et al 1999). However, Harrison and Waddell (2005) did not note any change in femoral-tibial alignment with the use of staples and a long leg cast.…”

Section: Closing-wedge Htomentioning

confidence: 97%

Opposite cortical fracture in high tibial osteotomy: lateral closing compared to the medial opening‐wedge technique

et al. 2008

View full text Add to dashboard Cite

Background and purpose The aim with high tibial valgus osteotomy (HTO) is to correct the mechanical axis in medial compartmental osteoarthritis of the knee. Loss of operative correction may threaten the long-term outcome. In both a lateral closing-wedge procedure and a medial opening-wedge procedure, the opposite cortex of the tibia is usually not osteotomized, leaving 1 cm of bone intact as fulcrum. A fracture of this cortex may, however, lead to loss of correction; this was examined in the present study.Patients and methods We used a prospective cohort of 92 consecutive patients previously reported by Brouwer et al. (2006). The goal in that randomized controlled trial, was to achieve a correction of 4 degrees in excess of physiological valgus. In retrospect, we evaluated the 1-year radiographic effect of opposite cortical fracture. Opposite cortical fracture was identified on the posteroanterior radiographs in supine position on the first day after surgery.Results 44 patients with a closing-wedge HTO (staples and cast fixation) and 43 patients with an openingwedge HTO (non-angular-stable plate fixation) were used for analysis. 36 patients (four-fifths) in the closingwedge group and 15 patients (one-third) in the opening-wedge group had an opposite cortical fracture (p < 0.001). At 1 year, the closing-wedge group with opposite cortical fracture had a valgus position with a mean HKA angle of 3.2 (SD 3.5) degrees of valgus. However, the opening-wedge group with disruption of the opposite cortex achieved varus malalignment with a mean HKA angle of 0.9 (SD 6.6) degrees of varus.

show abstract

Section: Closing-wedge Htomentioning

confidence: 97%

Opposite cortical fracture in high tibial osteotomy: lateral closing compared to the medial opening‐wedge technique

et al. 2008

View full text Add to dashboard Cite

show abstract

“…There is some disagreement concerning the correct postoperative alignment of the knee, but most authors recommend an overcorrection of 2-10° [5, 11, 14, 15, 17, 22, 26, 27, 30, 32, 35, 36, 46-49, 61, 63, 65, 66, 73]. In majority of cases the loss of the osseous correction can be detected after high tibial osteotomy [22,27,35,36]. The loss of the osseous correction can start shortly after the high tibial osteotomy indicating an insufficient osteotomy fixation.…”

Section: Discussionmentioning

confidence: 99%

“…-In contrast to hemicallotasis [35,36] at combined osteotomy, there is no possibility to modify the angular correction after operation during the bonehealing period. -In contrast to the focal dome osteotomy [51,52], there was transpositon of the tibial condyle after combined osteotomy.…”

Section: Discussionmentioning

confidence: 99%

The patella and tibial condyle position after combined and after closing wedge high tibial osteotomy

Papp

Csernátony

Kazai

et al. 2007

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

High tibial osteotomy changes the patella and tibial condyle position, which makes the subsequent total knee replacement technically demanding. From 1 January 1993 to 31 December 2000, combined osteotomy [After the first osteotomy made 2 cm distally to the joint line, a bone wedge is removed based laterally. Its tip ends at the center of the tibial condyle (half bone wedge). The distal part of the tibia is placed into the valgus position and the half bone wedge is placed into the gap opened medially.] was performed on 103 knees and closing wedge osteotomy was performed on 47 consecutive knees. Eighty combined (group A) and 41 closing wedge (group B) osteotomy were studied. All knees were assessed radiologically before surgery, in the 10th postoperative week, in the 12th postoperative month and at the time of the final follow-up (in group A-66.15 months, in group B-66.61 months). We examined the change of the femorotibial angle, of the patellar height according to the method of Insall and Salvati, of the tibial slope angle according to the method of Bonnin, of the tibial condylar offset according to the method of Yoshida and of the distance between the lateral tibial plateau and the top of the fibular head. In group A and B, the recurrence of the varus deformity was not noted and valgus alignment did not increase in any case. In group-A, the Insall-Salvati ratio remained unchanged in 65% of knees. The tibial slope angle decreased in both groups. There was correlation between the change of the tibial condylar offset and the angle of the correction in both groups. There was correlation between the change of the distance between the lateral tibial plateau and the top of the fibular head. After combined osteotomy, the transposition of the tibial condyle and the decrease of the distance between the lateral tibial plateau and the top of the fibular head was less than after closing wedge osteotomy, although the average angle of correction was more after combined osteotomy (11.835 degrees ), than after closing wedge osteotomy (9.465 degrees ). Theoretically, the recurrence of the varus deformity, the increase of the valgus alignment and (in majority of cases) the shortening of the patellar tendon do not compromise the likelihood of successful conversion to the subsequent total knee replacement, either after combined or after closing wedge osteotomy. The combined osteotomy does not lead to considerable transposition of the tibial condyle and to considerable lateral tibial bone loss; therefore, theoretically, the combined osteotomy does not impair the subsequent total knee replacement.

show abstract

“…However, Magyar et al [5], 1999, using radiostereometric analysis, found that the closing wedge technique had significantly higher rotations about the tibial axis after 1 month and 1 year when compared with the opening wedge surgical technique. The coronal plane osteotomy has not been examined to determine the amount of axial rotation that occurs when valgus correction is performed.…”

Section: Introductionmentioning

confidence: 99%

The Coronal Plane High Tibial Osteotomy. Part II: A Comparison of Axial Rotation with the Opening Wedge High Tibial Osteotomy

Baumgarten

Meyers

Fealy

et al. 2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

View full text Add to dashboard Cite

The amount of axial rotation in the tibia caused by high tibial osteotomy is relatively unknown. The authors hypothesize that the coronal plane high tibial osteotomy, a novel technique used to treat varus malalignment, alters the axial rotation of the tibia less than the opening wedge high tibial osteotomy. Eight, embalmed, stripped cadaveric tibia-fibula constructs with intact interosseous membranes were randomized to either opening wedge or coronal plane high tibial osteotomies. Sequential valgus corrections of 5-, 10-, and 15-were performed. The Qualisys Track Manager motion capture system was used to measure axial rotation. Student_s t test was used to compare axial rotation between the two groups. A p value of 0.05 was determined to be significant. The coronal plane technique produced rotations about the tibial axis that were statistically significantly smaller than those of the opening wedge technique for all correction angles (1.2-internal rotation (IR) vs 16-external rotation (ER), respectively, at 5-correction; p = 0.02) (3.5-IR vs 21.2-ER at 10-correction; p = 0.04) (4.5-IR vs 23.0-ER at 15-correction; p = 0.01). The coronal plane high tibial osteotomy alters axial rotation of the tibia significantly less than the opening wedge high tibial osteotomy.

show abstract

Changes in osseous correction after proximal tibial osteotomy: Radiostereometry of closed- and open-wedge osteotomy in 33 patients

Cited by 45 publications

References 22 publications

Opposite cortical fracture in high tibial osteotomy: lateral closing compared to the medial opening‐wedge technique

Opposite cortical fracture in high tibial osteotomy: lateral closing compared to the medial opening‐wedge technique

The patella and tibial condyle position after combined and after closing wedge high tibial osteotomy

The Coronal Plane High Tibial Osteotomy. Part II: A Comparison of Axial Rotation with the Opening Wedge High Tibial Osteotomy

Contact Info

Product

Resources

About