caa a22 4500 605456836 CHVBK 20210128100220.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00167-014-3100-8 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3100-8 Factors influencing posterior tibial slope and tibial rotation in opening wedge high tibial osteotomy [Elektronische Daten] [Matthias Jacobi, Vincent Villa, Nikolaus Reischl, Guillaume Demey, Damien Goy, Philippe Neyret, Emanuel Gautier, Robert Magnussen] 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. Springer-Verlag Berlin Heidelberg, 2014 Opening wedge high tibial osteotomy nationallicence Posterior tibial slope nationallicence Rotation nationallicence Osteoarthritis nationallicence Jacobi Matthias Orthopädie Rosenberg, Rorschacher Strasse 150, 9000, St. Gallen, Switzerland aut Villa Vincent Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut Reischl Nikolaus ProDoc, Gaswerkstrasse 1a, Graz, Austria aut Demey Guillaume Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut Goy Damien R&D Department, Tornier, St. Ismier Cedex, France aut Neyret Philippe Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut Gautier Emanuel Department of Orthopedic Surgery, HFR Hôpital cantonal, Fribourg, Switzerland aut Magnussen Robert Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/9(2015-09-01), 2762-2768 0942-2056 23:9<2762 2015 23 167 https://doi.org/10.1007/s00167-014-3100-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3100-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jacobi Matthias Orthopädie Rosenberg, Rorschacher Strasse 150, 9000, St. Gallen, Switzerland aut NATIONALLICENCE 700 1- Villa Vincent Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut NATIONALLICENCE 700 1- Reischl Nikolaus ProDoc, Gaswerkstrasse 1a, Graz, Austria aut NATIONALLICENCE 700 1- Demey Guillaume Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut NATIONALLICENCE 700 1- Goy Damien R&D Department, Tornier, St. Ismier Cedex, France aut NATIONALLICENCE 700 1- Neyret Philippe Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut NATIONALLICENCE 700 1- Gautier Emanuel Department of Orthopedic Surgery, HFR Hôpital cantonal, Fribourg, Switzerland aut NATIONALLICENCE 700 1- Magnussen Robert Department of Orthopedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/9(2015-09-01), 2762-2768 0942-2056 23:9<2762 2015 23 167