Vascular injuries during closing-wedge high tibial osteotomy: A cadaveric angiographic study
| Autor: | C. Debette, Sébastien Lustig, A. Darnis, Vincent Villa, P Neyret, Elvire Servien |
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| Přispěvatelé: | Laboratoire de Biomécanique et Mécanique des Chocs (LBMC UMR T9406), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR) |
| Rok vydání: | 2014 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.medical_treatment Osteoarthritis Osteotomy ANATOMICAL STUDY BIOMECANIQUE High tibial osteotomy Cadaver medicine.artery medicine Humans Popliteal Artery Orthopedics and Sports Medicine Tibia CLOSING-WEDGE business.industry Angiography [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph] Vascular System Injuries musculoskeletal system medicine.disease Popliteal artery Surgery Osteotome HIGH TIBIAL OSTEOTOMY business Cadaveric spasm VASCULAR INJURY |
| Zdroj: | Orthopaedics and Traumatology-Surgery and Research Orthopaedics and Traumatology-Surgery and Research, Elsevier, 2014, 100 (8), pp. 891-894. ⟨10.1016/j.otsr.2014.07.021⟩ |
| ISSN: | 1877-0568 |
| Popis: | Introduction Closing-wedge high tibial osteotomy is a surgical option for patients with isolated medial compartment osteoarthritis and varus knee alignment. Vascular complications are rare, but incriminate the use of oscillating saw or osteotome. It is important to know the steps of this surgery that involve risk of vascular injury and what to do to decrease that risk. Hypothesis Performing the distal osteotomy cut using an oscillating saw is a step with high risk of vascular injury. A protective device behind the tibia may decrease this risk. Materials and methods In this descriptive angiographic cadaver study, closing-wedge high tibial osteotomy was performed on 6 cadaveric knees in 90° knee flexion, and the distance between the surgical instrument and the popliteal artery was measured on fluoroscopy with artery opacification at the various steps of surgery. Results Tibial osteotomy with oscillating saw involves high vascular risk: the mean distance between the saw-blade and the popliteal artery is 10.6 mm in 90° knee flexion. Using a specific device placed behind the tibia protects the vascular structures. Discussion High tibial osteotomy is indicated in medial compartment osteoarthritis of the knee and can be performed by closing or opening-wedge. Vascular injuries in closing-wedge osteotomy exist and it is recommended to perform this surgery at 90° knee flexion, although some studies report that this does not move the artery out of the way. A risk of vascular lesion should be kept in mind. The oscillation of the saw and the direction of the osteotomy should also be taken into consideration when performing a closing-wedge high tibial osteotomy in order to protect the popliteal artery. Study design Descriptive cadaver study. Level IV. |
| Databáze: | OpenAIRE |
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