Vascular injuries during closing-wedge high tibial osteotomy: A cadaveric angiographic study

Kang

Orthopaedic Journal of Sports Medicine

et al. 2021

Background: Although a few studies have reported the incidence of deep vein thrombosis (DVT) after opening-wedge high tibial osteotomy (OWHTO), previous studies focused only on symptomatic DVT. Information is lacking regarding the overall incidence of DVT after OWHTO, thrombus location, and the relationship between DVT and clinical outcome. Purpose: To determine the overall incidence of DVT and classify the location of DVT after OWHTO. We also determined whether significant differences in clinical improvement exist in patients with and without DVT at 6 months and at 2 years after OWHTO. Study Design: Case-control study; Level of evidence, 3. Methods: This study included 46 patients (47 knees) who underwent OWHTO. All patients were instructed to perform knee range of motion exercises and partial weightbearing after drain removal. None of the patients received a chemoprophylaxis for DVT except intermittent pneumatic compression. DVT was diagnosed using 128-row multidetector computed tomography performed before discharge on the fourth postoperative day. The location was classified into 6 segments in the distal portion (muscular and axial veins) and proximal portion (popliteal, femoral, and common femoral veins and veins located above the iliac vein). International Knee Documentation Committee (IKDC) score was assessed preoperatively and postoperatively at 6 months, 1 year, and 2 years using a linear mixed model. Results: Although the incidence of symptomatic DVT was 8.5% (n = 4), the overall incidence of early DVT was 44.7% (n = 21). All DVTs were located in the distal portion of the lower extremity vein, and 76.2% of the DVTs were located in an axial vein. The IKDC scores were 33.6 ± 7.2 and 35.3 ± 9.1 ( P = .910) preoperatively, 38.1 ± 5.6 and 40.6 ± 8.4 ( P = .531) at 6 months after surgery, and 44.8 ± 6.9 and 45.9 ± 11.4 ( P = .786) at 2 years after surgery in patients without and those with DVT, respectively. Conclusion: The overall incidence of early DVT after OWHTO was 44.7%. DVT after OWHTO was found particularly around the osteotomy site (76.2%). Patients with DVT did not have inferior short-term clinical outcomes after surgery.

Section: Discussionmentioning

confidence: 94%

Patterns and Distribution of Deep Vein Thrombosis and Its Effects on Clinical Outcomes After Opening-Wedge High Tibial Osteotomy

Kang

Orthopaedic Journal of Sports Medicine

et al. 2021

Knee Surg Sports Traumatol Arthrosc

“…In a recent cadaver study, Darnis et al reported a mean distance of 10.6 mm between the saw blade and the popliteal artery in 90° of knee flexion. The authors recommend osteotomies in 90° of knee flexion, which is clinically unfeasible [5].…”

Section: Arterial Injuriesmentioning

confidence: 99%

Corrective osteotomies of the lower limb show a low intra- and perioperative complication rate—an analysis of 1003 patients

Schenke¹,

Dickschas²,

Simon³

et al. 2017

“…Çalışma sonucunda vasküler yapıları korumak için tibiaya direkt temas eden bir koruyucu alet konulmasını önermişler. [70]…”

Section: Vasküler Yaralanmaunclassified

Diz çevresi osteotomileri; komplikasyonlar, komplikasyonlardan korunma ve çözümleri

Doral¹,

Ayık²,

Karagüven³

2020

TOTBID

Türk Ortopedi ve Travmatoloji Birliği Derneği kompartmandan iletilmekte ve kıkırdak, subkondral kemik ve medial menisküste anormal bir strese neden olmaktadır. [2] Genelde medialden başlayan diz osteoartriti adeta bir kısır döngü halinde eklemin tamamına yayılmaktadır. Yüksek tibial osteotomi (YTO) ise bu kısır döngüyü, yükü lateral kompartmana kaydırarak kırma şansına sahiptir. Böylelikle dejenerasyonun önüne geçilmeye çalışılır. [3] YTO'nun temel olarak üç yöntemi vardır;• Kapalı kama,• Açık kama,• Kubbe yani "dome" osteotomisi. [4] A lt ekstremite mekanik aksı (ekseni), diz ekleminin kıkırdak yüzeylerinin aşınma durumu için önemlidir. Tarihsel süreçte diz çevresi osteotomileri, özellikle unikompartmantal diz osteoartritinin tedavi yöntemlerinden biri olmuştur. Fakat artroplastideki güncel gelişmeler ve yeni implantlar, osteotomiye olan ilgiyi azaltmaktaydı. Son yıllarda eklemin doğal durumunu korumak, gelecekteki olası artroplasti seçeneğini geciktirmek veya önlemek amacıyla unikompartmantal kondral patolojisi ve mekanik uyumsuzluğu olan genç hastalarda diz çevresi osteotomilerine olan ilgi tekrar artmıştır. Dizde varus deformitesi, osteoartritte en sık görülen mekanik dizilim bozukluğudur. [1] Alt ekstremitede varus dizilimi olduğu zaman ise yük anormal şekilde medial tibiofemoral Diz çevresi osteotomileri; komplikasyonlar, komplikasyonlardan korunma ve çözümleri Osteotomies around the knee; complications, prevention, and solutions