A lower starting point for the medial cut increases the posterior slope in opening-wedge high tibial osteotomy: a cadaveric study

Journal of Experimental Orthopaedics

Original Paper

Andrés Combalia¹  JoanLeal-Blanquet²  Juan Ignacio Erquicia²  Xavier Pelfort³  Sergi Gil-Gonzalez³  Maximiliano Ibañez⁴  Juan Carlos Monllau⁵ 

[1] Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Carrer Casanova 143, 08036, Barcelona, Spain;Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Carrer Casanova 143, 08036, Barcelona, Spain;Department of Orthopedic Surgery and Traumatology, Althaia Xarxa Assistencial Universitària de Manresa, Carrer Dr. Joan Soler, 1-3, 08243, Manresa, Spain;IMOVE, Mi Tres Torres, Av. Via Augusta, 281, 08017, Barcelona, Spain;Department of Orthopedic Surgery and Traumatology, Consorci Corporació Sanitària Parc Taulí. Universitat Autònoma de Barcelona (UAB), Parc del Taulí, 1, 08208, Sabadell, Spain;ICATME. Hospital Universitari Dexeus, Universitat Autònoma de Barcelona (UAB), Carrer de Sabino Arana 5, 08028, Barcelona, Spain;ICATME. Hospital Universitari Dexeus, Universitat Autònoma de Barcelona (UAB), Carrer de Sabino Arana 5, 08028, Barcelona, Spain;Department of Orthopedic Surgery and Traumatology. Hospital del Mar, Universitat Autònoma de Barcelona (UAB), Passeig Marítim, 25, 08003, Barcelona, Spain;

关键词: Anterior cruciate ligament;    Cadaveric study;    Lateral knee X-ray;    Medial starting point;    Posterior tibial slope;    Opening-wedge high tibial osteotomy;    Osteotomy;    Proximal anatomical axis;   

DOI  :  10.1186/s40634-022-00562-z

 received in 2022-09-30, accepted in 2022-12-16,  发布年份 2022

来源: Springer

【 摘 要 】

PurposeThe objective of this study was to evaluate the effects on the posterior tibial slope of different distances from the joint line to start the osteotomy and of varying the placement of the opening wedge in high tibial osteotomy.Starting the osteotomy more distally and an incorrect location for the tibial opening wedge were hypothesized to increase the posterior tibial slope.MethodsA cadaveric study was conducted using 12 knees divided into two groups based on the distance from the joint line to the start of the osteotomy: 3 and 4 cm. The preintervention posterior tibial slope was measured radiologically. Once the osteotomy was performed, the medial cortex of the tibia was divided into anteromedial, medial, and posteromedial thirds. A 10° opening wedge was sequentially placed in each third, and the effect on the posterior tibial slope was evaluated radiographically.Results: Significant changes were observed only in the 3-cm group (p = 0.02) when the wedge was placed in the anteromedial zone. In contrast, in the 4-cm group, significant differences were observed when the opening wedge was placed at both the medial (p = 0.04) and anteromedial (p = 0.012) zones.ConclusionCorrect control of the posterior tibial slope can be achieved by avoiding a low point when beginning the osteotomy and placing the opening wedge in the posteromedial third of the tibia when performing an opening-wedge high tibial osteotomy.Level of evidenceControlled laboratory study.

【 授权许可】

CC BY   
© The Author(s) 2022

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