[Precise, Computed-assisted Leg Angle Correction with Open-wedge High Tibial Osteotomy]

Overview

Journal Orthopade

Specialty Orthopedics

Date 2007 Apr 27

PMID 17458536

Citations 1

Authors

R Hart

V Stipcak

B Kucera

P Filan

J deCordeiro

Affiliations

Soon will be listed here.

Abstract

Aim: This prospective study investigates open-wedge high tibial osteotomy performed with the aid of a kinematic computer-guided navigation system. After the X-ray control the osteotomy was stabilized by internal LCP fixation. The aim of the study was to demonstrate the accuracy of the navigation system and to prove the reliability of the LCP fixation.

Method: A total of 39 patients were operated between 2002 and 2003 following this method. The outcomes were evaluated at least 2 years after the surgery clinically and radiologically; 21 females (1 female underwent bilateral osteotomy) and 18 males were included in the study sample.

Results: Prior to the osteotomy, the mean anatomic lateral tibiofemoral angle (aLTFA) was 181.1 degrees . The desired 4 degrees "overcorrection" of valgus (aLTFA 170 degrees) was found on X-rays postoperatively in all cases. The mean correction was 11.1 degrees. The correction achieved was stable during the 2-year follow-up period. The osteotomy healed in all cases after 4 months. The full range of motion remained after the surgery in all cases. All patients were satisfied with their results. The Lysholm score was 55 points before and 82 points after the osteotomy (27 points difference).

Conclusion: The computer-assisted open-wedge high tibial osteotomy with tricortical grafts stabilized by LCP fixation gives exact and reproducible results without loss of correction.

Citing Articles

[Quality of life and job performance resulting from operatively treated tibial plateau fractures].

Rossbach B, Faymonville C, Muller L, Stutzer H, Isenberg J Unfallchirurg. 2014; 119(1):27-35.

PMID: 25037262 DOI: 10.1007/s00113-014-2618-z.

References

Patel D, Ferris B, AICHROTH P . Radiological study of alignment after total knee replacement. Short radiographs or long radiographs?. Int Orthop. 1991; 15(3):209-10. DOI: 10.1007/BF00192296. View

Kettelkamp D, Chao E . A method for quantitative analysis of medial and lateral compression forces at the knee during standing. Clin Orthop Relat Res. 1972; 83:202-13. DOI: 10.1097/00003086-197203000-00037. View

Keppler P, Gebhard F, Grutzner P, Wang G, Zheng G, Hufner T . Computer aided high tibial open wedge osteotomy. Injury. 2004; 35 Suppl 1:S-A68-78. DOI: 10.1016/j.injury.2004.05.013. View

Hart R . [X-ray Analysis of the Axial Position of the Lower Extremity before and after High Tibial Arcuate Osteotomy.]. Acta Chir Orthop Traumatol Cech. 2010; 64(1):25-8. View

Huang T, Tseng K, Chen W, Ming-Hui Lin R, Wu J, Chen T . Preoperative tibiofemoral angle predicts survival of proximal tibia osteotomy. Clin Orthop Relat Res. 2005; (432):188-95. DOI: 10.1097/01.blo.0000149818.70975.07. View

Petersen T, Engh G . Radiographic assessment of knee alignment after total knee arthroplasty. J Arthroplasty. 1988; 3(1):67-72. DOI: 10.1016/s0883-5403(88)80054-8. View

COVENTRY M . OSTEOTOMY OF THE UPPER PORTION OF THE TIBIA FOR DEGENERATIVE ARTHRITIS OF THE KNEE. A PRELIMINARY REPORT. J Bone Joint Surg Am. 1965; 47:984-90. View

Hart R, Janecek M, Chaker A, Bucek P . Total knee arthroplasty implanted with and without kinematic navigation. Int Orthop. 2003; 27(6):366-9. PMC: 3461874. DOI: 10.1007/s00264-003-0501-6. View

Insall J, Joseph D, Msika C . High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am. 1984; 66(7):1040-8. View

10.

Ellis R, Tso C, Rudan J, Harrison M . A surgical planning and guidance system for high tibial osteotomy. Comput Aided Surg. 1999; 4(5):264-74. DOI: 10.1002/(SICI)1097-0150(1999)4:5<264::AID-IGS4>3.0.CO;2-E. View

11.

Hankemeier S, Hufner T, Wang G, Kendoff D, Zheng G, Richter M . Navigated intraoperative analysis of lower limb alignment. Arch Orthop Trauma Surg. 2005; 125(8):531-5. DOI: 10.1007/s00402-005-0038-9. View

12.

Saragaglia D, Roberts J . Navigated osteotomies around the knee in 170 patients with osteoarthritis secondary to genu varum. Orthopedics. 2005; 28(10 Suppl):s1269-74. DOI: 10.3928/0147-7447-20051002-13. View

13.

Yasuda K, Majima T, Tsuchida T, Kaneda K . A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res. 1992; (282):186-95. View

14.

Hernigou P, Medevielle D, DEBEYRE J, Goutallier D . Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am. 1987; 69(3):332-54. View

15.

Jakob R, Jacobi M . [Closing wedge osteotomy of the tibial head in treatment of single compartment arthrosis]. Orthopade. 2004; 33(2):143-52. DOI: 10.1007/s00132-003-0600-5. View

16.

Ivarsson I, Myrnerts R, Gillquist J . High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg Br. 1990; 72(2):238-44. DOI: 10.1302/0301-620X.72B2.2312563. View