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Open Wedge Tibial Osteotomies Influence On Axial Rotation And Tibial Slope

D. Kendoff, D. Lo, P. Goleski, B. Warkentine, P. F. O’ Loughlin, A. Pearle
Published 2008 · Medicine

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Inaccurate coronal plane and inadvertent sagittal plane realignment is a common problem after high tibial osteotomies (HTO). While the effects of an HTO on the coronal have been studied extensively, the influence on axial rotation has not been described in detail. The current study examines the effect of HTO on tibial rotation in the axial plane as determined by computed tomography. We hypothesized that high tibial osteotomies have an effect on tibial rotation in the axial plane and that depending on the predefined osteosynthetic implant used, a corresponding change in the tibial slope would occur. HTOs with a tapered 12.5 mm Puddu plate were performed on 13 limbs under computer-navigated control. All limbs were CT scanned before and after the HTO. Using specific software, the CT data was converted into 3D computer models and the following parameters compared: (a) varus-valgus leg alignment; (b) tibial axial rotation; (c) tibial slope (including determination of lateral and medial tibial slope, (d) leg length including determination of the tibial length. Results revealed: (a) a varus-valgus alignment increase of 11 ± 4.7° (P < 0.005); (b) an axial tibial rotation of 2.7 ± 6.3° (P < 0.075) occurred with external rotation in 10 out of 13 limbs (12° max external; 9.5° max internal); (c) tibial slope revealed differences of 4.2 ± 5.9° (P < 0.025); (d) the tibial length increased after HTO by 7.1 ± 3.7 mm (P < 0.005), while there was no significant change in overall leg length. In summary, tibial rotation does occur in high tibial osteotomies with though the degree of external rotation in this study tended not to be statiscally significant. Tapered implants do not guarantee maintenance of a steady tibial slope, while tibial length changes significantly when HTOs are performed. The combined use of CT and 3D software measurement techniques is reproducible and can be used without any further invasive fixation devices.
This paper references
How to avoid unintended increase of posterior slope in navigation-assisted open-wedge high tibial osteotomy.
E. Song (2007)
Open wedge tibial osteotomy: combined coronal and sagittal correction.
P. Hernigou (2002)
The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints.
Y. Fujisawa (1979)
Importance of Tibial Slope for Stability of the Posterior Cruciate Ligament—Deficient Knee
J. Robert Giffin (2007)
Medial Opening Wedge Tibial Osteotomy and the Sagittal Plane
Craig M. Rodner (2006)
In vitro effects of osteotomy angle and osteotomy reduction on tibial angulation and rotation during the tibial plateau-leveling osteotomy procedure.
J. Wheeler (2003)
Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study.
P. Hernigou (1987)
Re: Medial opening wedge tibial osteotomy and the sagittal plane: the effect of increasing tibial slope on tibiofemoral contact pressure.
J. Agneskirchner (2007)
Changes in osseous correction after proximal tibial osteotomy: radiostereometry of closed- and open-wedge osteotomy in 33 patients.
G. Magyar (1999)
Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees
J. Agneskirchner (2004)
Computer aided high tibial open wedge osteotomy.
P. Keppler (2004)
[Imaging and preoperative planning of osteotomy of tibial head osteotomy].
D. Pape (2004)
Navigated intraoperative analysis of lower limb alignment
S. Hankemeier (2005)
Effects of Increasing Tibial Slope on the Biomechanics of the Knee
J. Robert Giffin (2004)
[Long-term results of the treatment of medial femoro-tibial gonarthrosis by tibial valgisation osteotomy. Outcome of 93 osteotomies after more than 10 years].
D. Goutallier (1985)
The effect of closed wedge high tibial osteotomy on tibial slope: a radiographic study
E. Hohmann (2005)
Opening Wedge Tibial Osteotomy: The 3-Triangle Method to Correct Axial Alignment and Tibial Slope
F. Noyes (2005)
Computerassistierte valgisierende Tibiakopfosteotomie
R. Wiehe (2007)
The effect of high tibial osteotomy on osteoarthritis of the knee
T. Koshino (2004)
The Coronal Plane High Tibial Osteotomy. Part II: A Comparison of Axial Rotation with the Opening Wedge High Tibial Osteotomy
K. Baumgarten (2007)
[Computer-assisted open-wedge osteotomy].
R. Wiehe (2007)
Computer-assisted analysis of lower limb geometry: higher intraobserver reliability compared to conventional method
S. Hankemeier (2006)
Photoelastic study of the internal and contact stresses on the knee joint before and after osteotomy
G. Papachristou (2004)
Navigated open-wedge high tibial osteotomy: advantages and disadvantages compared to the conventional technique in a cadaver study
S. Hankemeier (2006)
Influence of lower limb rotation in navigated alignment analysis: implications for high tibial osteotomies
D. Kendoff (2007)
Effects of the amount of valgus correction for medial compartment knee osteoarthritis on clinical outcome, knee kinetics and muscle co‐contraction after opening wedge high tibial osteotomy
K. Briem (2007)
Bildgebung und präoperative Planung der Tibiakopfosteotomie
D. Pape (2004)
Normal axial alignment of the lower extremity and load-bearing distribution at the knee.
R. W. Hsu (1990)
High tibial osteotomy with Puddu plate for the treatment of varus gonarthrosis
M. Aşık (2006)

This paper is referenced by
Open-wedge high tibial osteotomy: comparison between manual and computer-assisted techniques
R. Iorio (2011)
Effect of soft tissue laxity of the knee joint on limb alignment correction in open-wedge high tibial osteotomy
D. Lee (2015)
Retro-tubercular gap widening can be caused by inappropriate anterior osteotomy and large opening gap in the medial biplanar open-wedge HTO
I. H. Jo (2018)
Computer-assisted high tibial osteotomy: preliminary results.
R. Iorio (2010)
Computer-assisted navigation decreases the change in the tibial posterior slope angle after closed-wedge high tibial osteotomy
D. K. Bae (2016)
Three-dimensional relationships between secondary changes and selective osteotomy parameters for biplane medial open-wedge high tibial osteotomy.
B. H. Lee (2017)
Short-term functional outcomes of computer assisted navigated high tibial osteotomy.
V. Sardana (2019)
Efficacité d’une agrafe contraignante à minimiser l’augmentation de la pente tibiale après ostéotomie tibiale de valgisation : étude comparative
F. Lavoie (2019)
A computer simulation study for preserving the tibial posterior slope in open-wedge high tibial osteotomy
M. Hanada (2020)
Total knee arthroplasty after high tibial osteotomy.
S. Cerciello (2014)
Osteotomia rozwierająca piszczeli w leczeniu choroby zwyrodnieniowej stawu kolanowego
Sergiew Marcin (2010)
No correction angle loss with stable plates in open-wedge high tibial osteotomy
M. Kim (2014)
Opening gap width influences distal tibial rotation below the osteotomy site following open wedge high tibial osteotomy
Junho Kim (2020)
The role of the tibial slope in sustaining and treating anterior cruciate ligament injuries
M. Feucht (2012)
Avoiding intraoperative complications in open-wedge high tibial valgus osteotomy: technical advancement
M. Jacobi (2009)
Effect of Tibial Cut Planes and Hinge Axes on Medial Opening Wedge High Tibial Osteotomy
Byoung-Keon Park (2011)
Surgical Treatment of Long-Bone Deformities: 3D Preoperative Planning and Patient-Specific Instrumentation
P. Fürnstahl (2016)
Computer-Assisted Navigation in High Tibial Osteotomy: A Systematic Review of the Literature
N. Picardo (2012)
Generic analytical osteotomy model for three-dimensional surgical planning in opening wedge high tibial osteotomy
D. K. Choi (2016)
Computer-assisted navigation for the intraoperative assessment of lower limb alignment in high tibial osteotomy can avoid outliers compared with the conventional technique
K. Reising (2012)
Tibial rotational alignment after opening-wedge and closing-wedge high tibial osteotomy
Ryosuke Kawai (2019)
Reliability of image-free navigation to monitor lower-limb alignment.
A. Pearle (2009)
Analysis of the effects of high tibial osteotomy on tibial rotation
S. Hinterwimmer (2015)
High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate (Position HTO plate) without bone substitute.
S. Schröter (2011)
Comparison of torsional changes in the tibia following a lateral closed or medial open wedge high tibial osteotomy.
U. Kuwashima (2019)
Gait analysis of walking before and after medial opening wedge high tibial osteotomy
M. Lind (2011)
Studying the effect of medial open wedge high tibial osteotomy on the posterior slope of tibia among patients with Genu varum
Seyyed Raza Sharifzadeh (2017)
Leg length change after opening wedge and closing wedge high tibial osteotomy: A meta-analysis
J. Kim (2017)
Patellar Height and Posterior Tibial Slope after Open- and Closed-Wedge High Tibial Osteotomy
H. El-Azab (2010)
Evaluation of satisfaction levels of patients undergoing high tibial osteotomy.
Sarper Gursu (2015)
Applications of computer-assisted surgery (CAS) in total knee arthroplasty (TKA)
R. Mugnai (2015)
Unintended Rotational Changes of the Distal Tibia After Biplane Medial Open-Wedge High Tibial Osteotomy.
K. Jang (2016)
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