Should sagittal osteotomy line be parallel to tibial posterior slope in high tibial osteotomy?

Autor: Y. Akamatsu, H. Kobayashi, M. Tsuji, S. Nejima, K. Kumagai, T. Saito
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: BMC Musculoskeletal Disorders, Vol 19, Iss 1, Pp 1-8 (2018)
Druh dokumentu: article
ISSN: 1471-2474
DOI: 10.1186/s12891-018-2257-6
Popis: Abstract Background The reason why the osteotomy line in the sagittal view should be parallel to the medial tibial posterior slope in open wedge high tibial osteotomy (OWHTO) remains unclear. In addition, previous study reported that a posterolateral hinge position led to an increase in tibial posterior slope (TPS) after OWHTO. Our aims were to examine the relationships between angles among the tibial plateau and osteotomy planes or the hinge point and the change in TPS, and the location of the hinge position after OWHTO using three-dimensional computed tomography (3DCT). We hypothesized that the sagittal angle between the tibial plateau and osteotomy planes with an anterior-widening proximal tibial fragment resulted in increased TPS, and the hinge position located posterolaterally. Methods Preoperative planning anticipated a weight-bearing line ratio of 62% on the radiograph. The anterior gap was 67% of the posterior gap in OWHTO. We identified the tibial plateau and upper and lower osteotomy planes on 3DCT of 82 patients with symptomatic medial osteoarthritic knee after OWHTO. The osteotomy plane angles between the tibial plateau and upper osteotomy planes, and opening gap angles between both osteotomy planes in the coronal and sagittal views were measured. The anteroposterior (AP) and lateral hinge position was displayed as a percentage on the upper osteotomy plane. We assessed the relationships among them. Results The TPS significantly increased after OWHTO (p = 0.002). There was no significant difference between the sagittal osteotomy plane angle and the change in TPS. The sagittal opening gap angle and the AP hinge position ratio were significantly correlated with the change in the TPS (r = 0.477 p
Databáze: Directory of Open Access Journals
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