Valgus Tibial Osteotomy

Engel, Gregory M.; Lippert, Frederick G.

doi:10.1097/00003086-198110000-00018

Cited by 57 publications

(18 citation statements)

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“…Navigation systems are of increasing importance in the field of orthopaedic surgery [20][21][22]. In terms of corrective osteotomies of the knee, long term outcome is influenced by the accuracy of the correction [5,7,16,23]. Intraoperative determination of the mechanical axis may be performed by the cable method, grids with leadimpregnated reference lines, or with the help of joint orientation angles [10,17,18].…”

Section: Discussionmentioning

confidence: 99%

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High tibial osteotomy (HTO) is an established technique for the treatment of symptomatic varus malaligned knees [2,6,7,9,11,13,15,23]. However, corrective osteotomies need to be precise as under-and overcorrection leads to disappointing clinical results [5,7,13,19,23]. Even small alterations of the mechanical axis cause significant changes of the load distribution of the knee joint [8], bearing a significant cause of early degenerative changes and dysfunction [19].

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confidence: 99%

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Navigated open-wedge high tibial osteotomy: advantages and disadvantages compared to the conventional technique in a cadaver study

Hankemeier

Hüfner

Wang

et al. 2006

Knee Surg Sports Traumatol Arthrosc

134

140

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High tibial osteotomy (HTO) is an established therapy for the treatment of symptomatic varus malaligned knees. A main reason for disappointing clinical results after HTO is the under- and overcorrection of the mechanical axis due to insufficient intraoperative visualisation. Twenty legs of fresh human cadaver were randomly assigned to navigated open-wedge HTO (n=10) or conventional HTO using the cable method (n=10). Regardless of the pre-existing alignment, the aim of all operations was to align the mechanical axis to pass through 80% of the tibial plateau (beginning with 0% at the medial edge of the tibial plateau and ending with 100% at the lateral edge). This overcorrection was chosen to ensure a sufficient amount of correction. Thus, the medial proximal tibia angle (MPTA) increased by 9.1+/-2.9 degrees (range 5.2 degrees -12.3 degrees ) on the average after navigated HTO and by 8.9+/-2.9 degrees (range 4.7 degrees -12.6 degrees ) after conventional HTO. After stabilization with a fixed angle implant, the alignment was measured by CT. After navigated HTO, the mechanical axis passed the tibial plateau through 79.7% (range 75.5-85.8%). In contrast, after conventional HTO, the average intersection of the mechanical axis was at 72.1% (range 60.4-82.4%) (P=0.020). Additionally, the variability of the mean corrections was significantly lower in the navigated group (3.3% vs. 7.2%, P=0.012). Total fluoroscopic radiation time was significantly lower in the navigated group (P=0.038) whereas the mean dose area product was not significantly different (P=0.231). The time of the operative procedure was 23 min shorter after conventional HTO (P<0.001). Navigation systems provide intraoperative 3-dimensional real time control of the frontal, sagittal, and transverse axis and may increase the accuracy of open-wedge HTO. Future studies have to analyse the clinical effects of navigation on corrective osteotomies.

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Section: Discussionmentioning

confidence: 99%

“…

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mentioning

confidence: 99%

Navigated open-wedge high tibial osteotomy: advantages and disadvantages compared to the conventional technique in a cadaver study

Hankemeier

Hüfner

Wang

et al. 2006

Knee Surg Sports Traumatol Arthrosc

134

140

View full text Add to dashboard Cite

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“…Osteotomies are performed with the aim to correct extra-articular deformities, particularly around the knee, as a pre-arthritic condition in symptomatic patients. The correct analysis of deformities is crucial [ 46 ]. Multiplanar deformities exist and are not rare, making either bifocal osteotomies or multiplanar osteotomies necessary, e.g., for the tibia, not just coronal but also sagittal planes (slope) have to be considered.…”

Section: Osteotomiesmentioning

confidence: 99%

Patient Specific Instruments and Patient Individual Implants—A Narrative Review

Benignus

Buschner

Meier

et al. 2023

JPM

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Joint arthroplasties are one of the most frequently performed standard operations worldwide. Patient individual instruments and patient individual implants represent an innovation that must prove its usefulness in further studies. However, promising results are emerging. Those implants seem to be a benefit especially in revision situations. Most experience is available in the field of knee and hip arthroplasty. Patient-specific instruments for the shoulder and upper ankle are much less common. Patient individual implants combine individual cutting blocks and implants, while patient individual instruments solely use individual cutting blocks in combination with off-the-shelf implants. This review summarizes the current data regarding the implantation of individual implants and the use of individual instruments.

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“…Correction of the weight-bearing axis to a predetermined point is the mechanical aim of the procedure [4]. Under-or overcorrection leads to early failure [7], hence careful pre-operative planning is now mandatory.…”

Section: Introductionmentioning

confidence: 99%