Yong Seuk Lee1, Gi Ho Moon. 1. Department of Orthopaedic Surgery, Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea, smcos1@hanmail.net.
Abstract
INTRODUCTION: Open-wedge high tibial osteotomy (OWHTO) is associated with potential intraoperative problems. For prevention of these problems, we thought that some surgical improvements were required and devised a protective cutting system (PCS). The purposes of this study were (1) to test our devised protective cutting system and (2) compare its accuracy in osteotomy to that of a conventional technique. MATERIALS AND METHODS: A comparative study was performed with 19 patients who underwent OWHTO with PCS (group I) and 16 patients who underwent OWHTO using a conventional technique (group II). For the evaluation of osteotomy accuracy, osteotomy lines of the anterior and posterior cortex were analyzed in the 3D surface models [Total (T), Osteotomy (O), Ratio (O/T), Effective osteotomy (E), Deviation direction (DD), and length (DL)]. Analysis of changes of the medial and lateral tibial slope was performed independently, and intraoperative complications were also analyzed. RESULTS: In the osteotomy line of the anterior aspect, O-anterior and Ratio (O- and T-anterior) showed statistical significance, and a larger osteotomy was observed in group II (p = 0.02 and 0.01, respectively). In the osteotomy line of the posterior aspect, Ratio (O- and T-posterior) and E-posterior showed statistical significance (p = 0.01 and 0.01, respectively). In the comparison between the change of the medial and lateral tibial slope, statistical significance was observed in both groups, and the medial tibial slope showed a larger increase than that of the lateral side (p = < 0.01 and <0.01, respectively). There were more intraoperative complications such as fracture and deviation of the osteotomy plane in group II, and this was more prominent at the posterior aspect. CONCLUSIONS: OWHTO with PCS could improve the accuracy of osteotomies, especially those of the posterior cortex of the proximal tibia, thus resulting in a reduction of intraoperative complications.
INTRODUCTION: Open-wedge high tibial osteotomy (OWHTO) is associated with potential intraoperative problems. For prevention of these problems, we thought that some surgical improvements were required and devised a protective cutting system (PCS). The purposes of this study were (1) to test our devised protective cutting system and (2) compare its accuracy in osteotomy to that of a conventional technique. MATERIALS AND METHODS: A comparative study was performed with 19 patients who underwent OWHTO with PCS (group I) and 16 patients who underwent OWHTO using a conventional technique (group II). For the evaluation of osteotomy accuracy, osteotomy lines of the anterior and posterior cortex were analyzed in the 3D surface models [Total (T), Osteotomy (O), Ratio (O/T), Effective osteotomy (E), Deviation direction (DD), and length (DL)]. Analysis of changes of the medial and lateral tibial slope was performed independently, and intraoperative complications were also analyzed. RESULTS: In the osteotomy line of the anterior aspect, O-anterior and Ratio (O- and T-anterior) showed statistical significance, and a larger osteotomy was observed in group II (p = 0.02 and 0.01, respectively). In the osteotomy line of the posterior aspect, Ratio (O- and T-posterior) and E-posterior showed statistical significance (p = 0.01 and 0.01, respectively). In the comparison between the change of the medial and lateral tibial slope, statistical significance was observed in both groups, and the medial tibial slope showed a larger increase than that of the lateral side (p = < 0.01 and <0.01, respectively). There were more intraoperative complications such as fracture and deviation of the osteotomy plane in group II, and this was more prominent at the posterior aspect. CONCLUSIONS: OWHTO with PCS could improve the accuracy of osteotomies, especially those of the posterior cortex of the proximal tibia, thus resulting in a reduction of intraoperative complications.
Authors: Jesse Chieh-Szu Yang; Cheng-Fong Chen; Chu-An Luo; Ming-Chau Chang; Oscar K Lee; Ye Huang; Shang-Chih Lin Journal: Biomed Res Int Date: 2018-05-08 Impact factor: 3.411
Authors: Corentin Pangaud; Pierre Laumonerie; Louis Dagneaux; Sally LiArno; Peter Wellings; Ahmad Faizan; Akash Sharma; Matthieu Ollivier Journal: Orthop J Sports Med Date: 2020-01-24