Comparison of Monoplanar Versus Biplanar Medial Opening-wedge High Tibial Osteotomy Techniques for Preventing Lateral Cortex Fracture

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2016 Feb 22

PMID 26897136

Citations 13

Authors

Faik Turkmen

Burkay K Kacira

Mustafa Ozkaya

Omer F Erkocak

Mehmet A Acar

Mustafa Ozer

Serdar Toker

Teyfik Demir

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to investigate the mechanical strength of both monoplanar and biplanar medial opening-wedge high tibial osteotomy (MOWHTO) procedures and assess the risk of lateral cortex disruption for both techniques.

Methods: Twelve synthetic tibia models with cortical shells were used as test models. Saw cuts for monoplanar MOWHTO and biplanar MOWHTO were generated on the test models in equal numbers (n = 6 for both groups). Wedge opening load and wedge gap distance were evaluated via compressive tests.

Results: The mean gap distance just before the lateral cortex fracture in the monoplanar group was 14.7 ± 2.9 mm, which was significantly narrower than that in the biplanar group of 19.1 ± 2.0 mm (p = 0.015). The mean load just before the occurrence of lateral cortex fracture of 32.4 ± 3.2 N in the monoplanar osteotomy group was significantly lower than that in the biplanar osteotomy group of 111.8 ± 9.3 N (p = 0.009).

Conclusion: Performing a MOWHTO via the biplanar rather than the monoplanar technique allows larger-sized wedges to be opened with less risk of lateral cortical fracture. Thus, larger gaps can be opened and higher angle corrections can be achieved using the biplanar osteotomy procedure. From a clinical viewpoint, the biplanar osteotomy technique reduced the risk of lateral cortical hinge fracture during MOWHTO.

Citing Articles

Required force for distraction during medial opening wedge high tibial osteotomy may serve as a predictive indicator for lateral hinge fracture.

Soykan B, Vahabi A, Kaya Bicer E, Uzun B, Aydogdu S J Exp Orthop. 2024; 11(3):e12086.

PMID: 38974049 PMC: 11227605. DOI: 10.1002/jeo2.12086.

The effects on joint functions of biplanar distal tubercle open-wedge high tibial osteotomy: A prospective study.

Zehir S, Alic T Medicine (Baltimore). 2023; 102(36):e34980.

PMID: 37682148 PMC: 10489461. DOI: 10.1097/MD.0000000000034980.

Lateral hinge fracture in medial opening wedge high tibial osteotomy: a narrative review.

Franulic N, Munoz J, Figueroa F, Innocenti P, Gaggero N EFORT Open Rev. 2023; 8(7):572-580.

PMID: 37395709 PMC: 10321048. DOI: 10.1530/EOR-22-0103.

Risk Factors for Increase in Posterior Slope After Medial Open-Wedge High Tibial Osteotomy.

Song J, Bin S, Kim J, Lee B, Park J, Lee S Orthop J Sports Med. 2022; 10(11):23259671221137042.

PMID: 36419475 PMC: 9676332. DOI: 10.1177/23259671221137042.

Distal tibial tubercle osteotomy can lessen change in patellar height post medial opening wedge high tibial osteotomy? A systematic review and meta-analysis.

Ren Y, Tian M, Duan Y, Sun Y, Yang T, Hou W J Orthop Surg Res. 2022; 17(1):341.

PMID: 35794572 PMC: 9258196. DOI: 10.1186/s13018-022-03231-0.

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