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18.02.2022 | Leitthema

Analyse der Beingeometrie bei komplexen Beindeformitäten

verfasst von: Prof. Dr. Steffen Schröter, Jörg Harrer

Erschienen in: Knie Journal | Ausgabe 1/2022

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Zusammenfassung

Der Artikel soll einen Überblick über die Grundlagen der Deformitätenanalyse der unteren Extremität in allen Raumebenen geben. Insbesondere bei komplexen Deformitäten ist die gesamte Betrachtung und Beurteilung von entscheidender Bedeutung. Unterschiedliche geometrische Überlegungen und Definitionen bieten die Basis für die Planung. Messmethoden in der koronaren, sagittalen und axialen Ebene werden dargestellt und beschrieben.

Agneskirchner JD, Hurschler C, Stukenborg-Colsman C et al (2004) Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004. Arch Orthop Trauma Surg 124:575–584PubMed

Agneskirchner JD, Freiling D, Hurschler C et al (2006) Primary stability of four different implants for opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 14:291–300PubMed

Agneskirchner JD, Hurschler C, Wrann CD et al (2007) The effects of valgus medial opening wedge high tibial osteotomy on articular cartilage pressure of the knee: a biomechanical study. Arthroscopy 23:852–861PubMed

Ahrend MD, Baumgartner H, Ihle C et al (2021) Influence of axial limb rotation on radiographic lower limb alignment: a systematic review. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-04163-wCrossRefPubMed

Ahrend MD, Rühle M, Springer F et al (2021) Distance from the magnification device contributes to differences in lower leg length measured in patients with TSF correction. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-03831-1CrossRefPubMed

Amendola A, Rorabeck CH, Bourne RB et al (1989) Total knee arthroplasty following high tibial osteotomy for osteoarthritis. J Arthroplasty 4(Suppl):S11–S17PubMed

Baker PN, Van Der Meulen JH, Lewsey J et al (2007) The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg Br 89:893–900PubMed

Bayliss LE, Culliford D, Monk AP et al (2017) The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet 389:1424–1430PubMedPubMedCentral

Benjamin A (1969) Double osteotomy for the painful knee in rheumatoid arthritis and osteoarthritis. J Bone Joint Surg Br 51:694–699PubMed

10.

Benjamin A (1974) Double osteotomy of the knee. Scand J Rheumatol 3:65PubMed

11.

Boesecke R, Bruckner T, Ende G (1990) Landmark based correlation of medical images. Phys Med Biol 35:121–126

12.

Bonin N, Ait Si Selmi T, Dejour D et al (2004) Knee para-articular flexion and extension osteotomies in adults. Orthopade 33:193–200PubMed

13.

Brazier J, Migaud H, Gougeon F et al (1996) Evaluation of methods for radiographic measurement of the tibial slope. A study of 83 healthy knees. Rev Chir Orthop Reparatrice Appar Mot 82:195–200PubMed

14.

Brett AL (1935) Operative correction of genu recurvatum. J Bone Joint Surg Am 17:984–989

15.

Christensen JJ, Krych AJ, Engasser WM et al (2015) Lateral tibial posterior slope is increased in patients with early graft failure after anterior cruciate ligament reconstruction. Am J Sports Med 43:2510–2514PubMed

16.

Cotic M, Vogt S, Feucht MJ et al (2015) Prospective evaluation of a new plate fixator for valgus-producing medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23:3707–3716PubMed

17.

Coventry MB (1965) Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am 47:984–990PubMed

18.

Coventry MB (1973) Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am 55:23–48PubMed

19.

Coventry MB (1979) Upper tibial osteotomy for gonarthrosis. The evolution of the operation in the last 18 years and long term results. Orthop Clin North Am 10:191–210PubMed

20.

Coventry MB (1987) Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee. J Bone Joint Surg Am 69:32–38PubMed

21.

Debeyre J, Artigou JM (1973) Indications and results of tibial osteotomy. Influence of laxity. Rev Chir Orthop Reparatrice Appar Mot 59:641–656PubMed

22.

Debeyre J, Patte D (1961) The place of corrective osteotomies in the treatment of gonarthrosis. Acta Orthop Belg 27:374–383PubMed

23.

Dejour D, Bonin N, Locatelli E (2000) Tibial antirecurvatum osteotomies. Oper Tech Sports Med 8:67–70

24.

Dickschas J, Harrer J, Reuter B et al (2015) Torsional osteotomies of the femur. J Orthop Res 33:318–324PubMed

25.

Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264

26.

Elson DW (2017) The surgical accuracy of knee osteotomy. Knee 24:167–169PubMed

27.

Elson DW, Petheram TG, Dawson MJ (2015) High reliability in digital planning of medial opening wedge high tibial osteotomy, using Miniaci’s method. Knee Surg Sports Traumatol Arthrosc 23:2041–2048PubMed

28.

Feucht MJ, Mauro CS, Brucker PU et al (2013) The role of the tibial slope in sustaining and treating anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc 21:134–145PubMed

29.

Feucht MJ, Minzlaff P, Saier T et al (2014) Degree of axis correction in valgus high tibial osteotomy: proposal of an individualised approach. Int Orthop 38:2273–2280PubMed

30.

Frank W, Oest O, Rettig H (1974) The total x‑ray-picture in the planning of correction-osteotomy-operations on legs. Z Orthop Ihre Grenzgeb 112:344–347 ((author’s transl))PubMed

31.

Freiling D, Van Heerwaarden R, Staubli A et al (2010) The medial closed-wedge osteotomy of the distal femur for the treatment of unicompartmental lateral osteoarthritis of the knee. Oper Orthop Traumatol 22:317–334PubMed

32.

Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10:585–608PubMed

33.

Glasser O (1995) W. C. Roentgen and the discovery of the Roentgen rays. AJR Am J Roentgenol 165:1033–1040PubMed

34.

Gwinner C, Weiler A, Roider M et al (2017) Tibial slope strongly influences knee stability after posterior cruciate ligament reconstruction: a prospective 5‑ to 15-year follow-up. Am J Sports Med 45(2):355–361PubMed

35.

Harris WR, Kostuik JP (1970) High tibial osteotomy for osteo-arthritis of the knee. J Bone Joint Surg Am 52:330–336PubMed

36.

Healy WL, Riley LH Jr (1986) High tibial valgus osteotomy. A clinical review. Clin Orthop Relat Res 209:227–233

37.

Herman B, Litchfield R, Getgood A (2015) Role of osteotomy in posterolateral instability of the knee. J Knee Surg 28:441–449PubMed

38.

Hernandez RJ, Tachdjian MO, Poznanski AK et al (1981) CT determination of femoral torsion. AJR Am J Roentgenol 137:97–101PubMed

39.

Hernigou P (2002) Open wedge tibial osteotomy: combined coronal and sagittal correction. Knee 9:15–20PubMed

40.

Hernigou P, Ma W (2001) Open wedge tibial osteotomy with acrylic bone cement as bone substitute. Knee 8:103–110PubMed

41.

Hernigou P, Medevielle D, Debeyre J et al (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69:332–354PubMed

42.

Hunt MA, Fowler PJ, Birmingham TB et al (2006) Foot rotational effects on radiographic measures of lower limb alignment. Can J Surg 49:401–406PubMedPubMedCentral

43.

Imhoff FB, Scheiderer B, Zakko P et al (2017) How to avoid unintended valgus alignment in distal femoral derotational osteotomy for treatment of femoral torsional malalignment—a concept study. BMC Musculoskelet Disord 18:553PubMedPubMedCentral

44.

Jackson JP, Waugh W, Green JP (1969) High tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 51:88–94PubMed

45.

Jakob RP, Haertel M, Stussi E (1980) Tibial torsion calculated by computerised tomography and compared to other methods of measurement. J Bone Joint Surg Br 62-B:238–242PubMed

46.

Jarrett DY, Oliveira AM, Zou KH et al (2010) Axial oblique CT to assess femoral anteversion. AJR Am J Roentgenol 194:1230–1233PubMed

47.

Johnson F, Leitl S, Waugh W (1980) The distribution of load across the knee. A comparison of static and dynamic measurements. J Bone Joint Surg Br 62:346–349PubMed

48.

Kaiser P, Attal R, Kammerer M et al (2016) Significant differences in femoral torsion values depending on the CT measurement technique. Arch Orthop Trauma Surg 136(9):1259–1264PubMedPubMedCentral

49.

Keller G, Afat S, Ahrend MD et al (2021) Diagnostic accuracy of ultra-low-dose CT for torsion measurement of the lower limb. Eur Radiol 31:3574–3581PubMed

50.

Kettelkamp DB, Wenger DR, Chao EY et al (1976) Results of proximal tibial osteotomy. The effects of tibiofemoral angle, stance-phase flexion-extension, and medial-plateau force. J Bone Joint Surg Am 58:952–960PubMed

51.

Kim TW, Lee S, Yoon JR et al (2017) Proximal tibial anterior open-wedge oblique osteotomy: a novel technique to correct genu recurvatum. Knee 24:345–353PubMed

52.

Konrads C, Ahrend MD, Beyer MR et al (2020) Rotation osteotomy of the distal femur influences coronal femoral alignment and the ischiofemoral space. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-020-03704-zCrossRefPubMed

53.

Le Damany P (1909) La torsion du tibia, normale, pathologique, expérimentale. J Anat Physiol 45:598–615

54.

Lecuire F, Lerat JL, Bousquet G et al (1980) The treatment of genu recurvatum. Rev Chir Orthop Reparatrice Appar Mot 66:95–103 ((author’s transl))PubMed

55.

Liodakis E, Doxastaki I, Chu K et al (2012) Reliability of the assessment of lower limb torsion using computed tomography: analysis of five different techniques. Skeletal Radiol 41:305–311PubMed

56.

Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11:132–138PubMed

57.

Macewen W (1880) Osteotomy—with an inquiry into the aetiology and pathology of knock-knee, bow-leg and other osseous deformities of the lower limbs. J. & A. Churchill, London

58.

Maderbacher G, Baier C, Benditz A et al (2017) Presence of rotational errors in long leg radiographs after total knee arthroplasty and impact on measured lower limb and component alignment. Int Orthop 41:1553–1560PubMed

59.

Maquet P (1976) Valgus osteotomy for osteoarthritis of the knee. Clin Orthop Relat Res 120:143–148

60.

Marti CB, Gautier E, Wachtl SW et al (2004) Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy 20:366–372PubMed

61.

Marx RG, Grimm P, Lillemoe KA et al (2011) Reliability of lower extremity alignment measurement using radiographs and PACS. Knee Surg Sports Traumatol Arthrosc 19(10):1693–1698PubMed

62.

Mesgarzadeh M, Revesz G, Bonakdarpour A (1987) Femoral neck torsion angle measurement by computed tomography. J Comput Assist Tomogr 11:799–803PubMed

63.

Miniaci A, Ballmer FT, Ballmer PM et al (1989) Proximal tibial osteotomy. A new fixation device. Clin Orthop Relat Res 246:250–259

64.

Moore TM, Harvey JP Jr (1974) Roentgenographic measurement of tibial-plateau depression due to fracture. J Bone Joint Surg Am 56:155–160PubMed

65.

Moroni A, Pezzuto V, Pompili M et al (1992) Proximal osteotomy of the tibia for the treatment of genu recurvatum in adults. J Bone Joint Surg Am 74:577–586PubMed

66.

Muller M, Strecker W (2008) Arthroscopy prior to osteotomy around the knee? Arch Orthop Trauma Surg 128:1217–1221PubMed

67.

Murphy SB, Simon SR, Kijewski PK et al (1987) Femoral anteversion. J Bone Joint Surg Am 69:1169–1176

68.

Nyland J, Caborn DN, Jakob R (2014) Early surrender to knee arthroplasty.... Not so fast.... Let the knee tissue preservation and function sustainability dialogue begin! Knee Surg Sports Traumatol Arthrosc 22:2583–2584PubMed

69.

Ogata K, Yoshii I, Kawamura H et al (1991) Standing radiographs cannot determine the correction in high tibial osteotomy. J Bone Joint Surg Br 73-B:927–931

70.

Paley D (2002) Normal lower limb alignment and joint orientation. In: Principles of deformity correction. Springer, Berlin, Heidelberg https://doi.org/10.1007/978-3-642-59373-4_1CrossRef

71.

Paley D (2002) Radiographic assessment of lower limb deformities. In: Principles of deformity correction. Springer, Berlin, Heidelberg, S 31–60 https://doi.org/10.1007/978-3-642-59373-4_3CrossRef

72.

Paley D (2002) Osteotomy concepts and frontal plane realignment. In: Principles of deformity correction. Springer, Berlin, Heidelberg https://doi.org/10.1007/978-3-642-59373-4_5CrossRef

73.

Paley D, Herzenberg J (2005) Principles of deformity correction. Springer, Berlin, Heidelberg, New York

74.

Paley D, Herzenberg JE, Tetsworth K et al (1994) Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am 25:425–465PubMed

75.

Paley D, Pfeil J (2000) Principles of deformity correction around the knee. Orthopade 29:18–38PubMed

76.

Pape D, Adam F, Rupp S et al (2004) Stability, bone healing and loss of correction after valgus realignment of the tibial head. A roentgen stereometry analysis. Orthopade 33:208–217PubMed

77.

Paulos L, Swanson SC, Stoddard GJ et al (2009) Surgical correction of limb malalignment for instability of the patella: a comparison of 2 techniques. Am J Sports Med 37:1288–1300PubMed

78.

Peck CN, Childs J, McLauchlan GJ (2014) Inferior outcomes of total knee replacement in early radiological stages of osteoarthritis. Knee 21:1229–1232PubMed

79.

Petersen W, Forkel P (2013) Medial closing wedge osteotomy for correction of genu valgum and torsional malalignment. Oper Orthop Traumatol 25:593–607 (quiz 608)PubMed

80.

Petersen W, Wall A, Paulin T et al (2014) Stability of two angular stable locking plates for open wedge high tibial osteotomy (HTO): TomoFix versus LOQTEQ(R) HTO plate. Arch Orthop Trauma Surg 134:1437–1442PubMed

81.

Rahnemai-Azar AA, Abebe ES, Johnson P et al (2016) Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-016-4157-3CrossRefPubMed

82.

Schmaranzer F, Kallini JR, Miller PE et al (2020) The effect of modality and landmark selection on MRI and CT femoral torsion angles. Radiology 296:381–390

83.

Schröter S, Ihle C, Mueller J et al (2013) Digital planning of high tibial osteotomy. Interrater reliability by using two different software. Knee Surg Sports Traumatol Arthrosc 21:189–196PubMed

84.

Schröter S, Ihle C, Elson DW et al (2016) Surgical accuracy in high tibial osteotomy: coronal equivalence of computer navigation and gap measurement. Knee Surg Sports Traumatol Arthrosc 24:3410–3417PubMed

85.

Schröter S, Elson DW, Ateschrang A et al (2017) Lower limb deformity analysis and the planning of an osteotomy. J Knee Surg 30:393–408PubMed

86.

Schröter S, Nakayama H, Ihle C et al (2019) Torsional osteotomy. J Knee Surg 33(5):486–495PubMed

87.

Segev E, Hemo Y, Wientroub S et al (2010) Intra- and interobserver reliability analysis of digital radiographic measurements for pediatric orthopedic parameters using a novel PACS integrated computer software program. J Child Orthop 4:331–341PubMedPubMedCentral

88.

Seil R, Van Heerwaarden R, Lobenhoffer P et al (2013) The rapid evolution of knee osteotomies. Knee Surg Sports Traumatol Arthrosc 21:1–2PubMed

89.

Sled EA, Sheehy LM, Felson DT et al (2011) Reliability of lower limb alignment measures using an established landmark-based method with a customized computer software program. Rheumatol Int 31:71–77PubMed

90.

Spahn G, Wittig R (2002) Primary stability of various implants in tibial opening wedge osteotomy: a biomechanical study. J Orthop Sci 7:683–687PubMed

91.

Specogna AV, Birmingham TB, Dasilva JJ et al (2004) Reliability of lower limb frontal plane alignment measurements using plain radiographs and digitized images. J Knee Surg 17:203–210PubMed

92.

Stanley JC, Robinson KG, Devitt BM et al (2016) Computer assisted alignment of opening wedge high tibial osteotomy provides limited improvement of radiographic outcomes compared to flouroscopic alignment. Knee 23:289–294PubMed

93.

Staubli AE, De Simoni C, Babst R et al (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia—early results in 92 cases. Injury 34(Suppl 2):B55–B62PubMed

94.

Stoffel K, Stachowiak G, Kuster M (2004) Open wedge high tibial osteotomy: biomechanical investigation of the modified Arthrex Osteotomy Plate (Puddu Plate) and the TomoFix Plate. Clin Biomech 19:944–950

95.

Strecker W (2006) Planning analysis of knee-adjacent deformities. I. Frontal plane deformities. Oper Orthop Traumatol 18:259–272PubMed

96.

Strecker W, Keppler P, Gebhard F et al (1997) Length and torsion of the lower limb. J Bone Joint Surg Br 79:1019–1023PubMed

97.

Takai S, Sakakida K, Yamashita F et al (1985) Rotational alignment of the lower limb in osteoarthritis of the knee. Int Orthop 9:209–215PubMed

98.

Turner MS, Smillie IS (1981) The effect of tibial torsion of the pathology of the knee. J Bone Joint Surg Br 63-B:396–398PubMed

99.

Van Den Bempt M, Van Genechten W, Claes T et al (2016) How accurately does high tibial osteotomy correct the mechanical axis of an arthritic varus knee? A systematic review. Knee 23(6):925–935PubMed

100.

Vicenzi G, Moroni A, Ceccarelli F et al (1986) Tibial osteotomy in the treatment of genu recurvatum in the adult. Ital J Orthop Traumatol 12:427–432PubMed

101.

Waidelich HA, Strecker W, Schneider E (1992) Computed tomographic torsion-angle and length measurement of the lower extremity. The methods, normal values and radiation load. Rofo 157:245–251PubMed

102.

Yoshioka Y, Cooke TD (1987) Femoral anteversion: assessment based on function axes. J Orthop Res 5:86–91PubMed

103.

Zampogna B, Vasta S, Amendola A et al (2015) Assessing lower limb alignment: comparison of standard knee Xray vs long leg view. Iowa Orthop J 35:49–54PubMedPubMedCentral

Titel: Analyse der Beingeometrie bei komplexen Beindeformitäten
verfasst von: Prof. Dr. Steffen Schröter
Jörg Harrer
Publikationsdatum: 18.02.2022
Verlag: Springer Medizin
Erschienen in: Knie Journal / Ausgabe 1/2022
Print ISSN: 2662-4028
Elektronische ISSN: 2662-4036
DOI: https://doi.org/10.1007/s43205-022-00144-0

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