Factors influencing posterior tibial slope and tibial rotation in opening wedge high tibial osteotomy

Verfasser / Beitragende:
[Matthias Jacobi, Vincent Villa, Nikolaus Reischl, Guillaume Demey, Damien Goy, Philippe Neyret, Emanuel Gautier, Robert Magnussen]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/9(2015-09-01), 2762-2768
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-014-3100-8  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-3100-8 
245 0 0 |a Factors influencing posterior tibial slope and tibial rotation in opening wedge high tibial osteotomy  |h [Elektronische Daten]  |c [Matthias Jacobi, Vincent Villa, Nikolaus Reischl, Guillaume Demey, Damien Goy, Philippe Neyret, Emanuel Gautier, Robert Magnussen] 
520 3 |a Purpose: Opening wedge high tibial osteotomy (HTO) is an accepted treatment option for medial compartment knee osteoarthritis with associated varus lower limb axis in younger, more active patients. A concern with the use of this technique is that posterior tibial slope (PTS) and tibial rotation can be altered. We hypothesized that there is a tendency to increase the PTS and internal rotation of the distal tibia during the procedure and that certain intra-operative parameters may influence the amount of change that can be expected. Methods: A cadaveric model and surgical navigation system were used to evaluate the influence of certain intra-operative factors of the degree of PTS and tibial rotation change observed during medial opening HTO. Parameters evaluated included: degree of osteotomy opening, knee flexion angle, location of limb support (thigh versus foot), performance of a posteromedial release, the status of the lateral cortical hinge, and the degree of osteoarthritis present in the knee. Results: Combining measurements of all specimens and parameters, a mean PTS increase of 2.7°±3.9° and a mean tibial internal rotation of 1.5°±2.9° were observed. Clinically, significant changes in tibial slope (>2°) occurred in 50.4% of corrections, while significant changes in tibial rotation (>5°) occurred in only 11.9% of corrections. Patients with significant osteoarthritis and concomitant flexion contracture, cases where large corrections were required, and procedures in which the lateral cortical hinge was disrupted were associated with increased PTS change. The other factors evaluated did not exert a significant influence of the degree of PTS change observed. Conclusions: Surgeons should be vigilant for possible PTS change, particularly in high-risk situations as outlined above. Routine use of an intra-operative measure of PTS is recommended to avoid inadvertent slope change. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Opening wedge high tibial osteotomy  |2 nationallicence 
690 7 |a Posterior tibial slope  |2 nationallicence 
690 7 |a Rotation  |2 nationallicence 
690 7 |a Osteoarthritis  |2 nationallicence 
700 1 |a Jacobi  |D Matthias  |u Orthopädie Rosenberg, Rorschacher Strasse 150, 9000, St. Gallen, Switzerland  |4 aut 
700 1 |a Villa  |D Vincent  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
700 1 |a Reischl  |D Nikolaus  |u ProDoc, Gaswerkstrasse 1a, Graz, Austria  |4 aut 
700 1 |a Demey  |D Guillaume  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
700 1 |a Goy  |D Damien  |u R&D Department, Tornier, St. Ismier Cedex, France  |4 aut 
700 1 |a Neyret  |D Philippe  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
700 1 |a Gautier  |D Emanuel  |u Department of Orthopedic Surgery, HFR Hôpital cantonal, Fribourg, Switzerland  |4 aut 
700 1 |a Magnussen  |D Robert  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/9(2015-09-01), 2762-2768  |x 0942-2056  |q 23:9<2762  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-3100-8  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-3100-8  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Jacobi  |D Matthias  |u Orthopädie Rosenberg, Rorschacher Strasse 150, 9000, St. Gallen, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Villa  |D Vincent  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Reischl  |D Nikolaus  |u ProDoc, Gaswerkstrasse 1a, Graz, Austria  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Demey  |D Guillaume  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Goy  |D Damien  |u R&D Department, Tornier, St. Ismier Cedex, France  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Neyret  |D Philippe  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Gautier  |D Emanuel  |u Department of Orthopedic Surgery, HFR Hôpital cantonal, Fribourg, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Magnussen  |D Robert  |u Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/9(2015-09-01), 2762-2768  |x 0942-2056  |q 23:9<2762  |1 2015  |2 23  |o 167