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Knee Surgery, Sports Traumatology, Arthroscopy
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2021

28.09.2020 | KNEE

Increased contact area of flange and decreased wedge volume of osteotomy site by open wedge distal tibial tuberosity arc osteotomy compared to the conventional technique

verfasst von: Shuntaro Nejima, Ken Kumagai, Hiroshi Fujimaki, Shunsuke Yamada, Masaichi Sotozawa, Joji Matsubara, Yutaka Inaba

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2021

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Abstract

Purpose

The purpose of this study was to evaluate the area of the osteotomy surface, including the flange and wedge volume, in open wedge high tibial osteotomy (OWHTO), distal tibial tuberosity osteotomy (DTO), and distal tibial tuberosity arc osteotomy (DTAO) using tibial sawbones. It was hypothesized that the area of the osteotomy surface, including the flange, in DTAO was larger than that in OWHTO and DTO and that the wedge volume in DTAO was smaller than that in OWHTO and DTO.

Methods

Fifteen tibial sawbones were divided equally into three groups: OWHTO, DTO, and DTAO. The total area of the osteotomy surface in OWHTO, DTO, and DTAO was compared using image analysis software. The contact area of the flange and the wedge volume at wedge heights of 5, 10, and 15 mm were compared among osteotomy types. One-way repeated-measures analysis of variance was used to compare the total area of the osteotomy surface, the contact area of the flange, and the wedge volume at 5, 10, and 15 mm in OWHTO, DTO, and DTAO.

Results

The total area of the osteotomy surface in DTO and DTAO was significantly larger than that in OWHTO (P < 0.05). The contact area of the flange in DTAO was significantly larger than that in OWHTO at each wedge height (P < 0.05). In addition, the contact area of the flange in DTAO was significantly larger than that in DTO at wedge heights of 5 and 15 mm (P < 0.05). The wedge volume in DTAO was significantly smaller than that in DTO at each wedge height (P < 0.05).

Conclusions

This study demonstrated that an increase in the flange contact area and a decrease in the wedge volume in the opening gap were found in DTAO compared to DTO. This would be an advantage for anteroposterior screw insertion from the flange to the distal tibial fragment and bone union at the osteotomy site.
Literatur
1.
Akiyama T, Osano K, Mizu-Uchi H, Nakamura N, Okazaki K, Nakayama H, Takeuchi R (2019) Distal tibial tuberosity arc osteotomy in open-wedge proximal tibial osteotomy to prevent patella infera. Arthrosc Tech 8:e655–e662CrossRef
2.
Amis AA (2013) Biomechanics of high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 21:197–205CrossRef
3.
Bito H, Takeuchi R, Kumagai K, Aratake M, Saito I, Hayashi R, Sasaki Y, Saito T (2010) Opening wedge high tibial osteotomy affects both the lateral patellar tilt and patellar height. Knee Surg Sports Traumatol Arthrosc 18:955–960CrossRef
4.
Brouwer RW, Bierma-Zeinstra SMA, van Koeveringe AJ, Verhaar JAN (2005) Patellar height and the inclination of the tibial plateau after high tibial osteotomy. The open versus the closed-wedge technique. J Bone Joint Surg Br 87:1227–1232CrossRef
5.
El-Azab H, Glabgly P, Paul J, Imhoff AB, Hinterwimmer S (2010) Patellar height and posterior tibial slope after open- and closed-wedge high tibial osteotomy: a radiological study on 100 patients. Am J Sports Med 38:323–329CrossRef
6.
Elmalı N, Esenkaya I, Can M, Karakaplan M (2013) Monoplanar versus biplanar medial open-wedge proximal tibial osteotomy for varus gonarthrosis: a comparison of clinical and radiological outcomes. Knee Surg Sports Traumatol Arthrosc 21:2689–2695CrossRef
7.
Esenkaya I, Unay K (2012) Proximal medial tibial biplanar retrotubercle open wedge osteotomy in medial knee arthrosis. Knee 19:416–421CrossRef
8.
Gaasbeek RDA, Sonneveld H, van Heerwaarden RJ, Jacobs WCH, Wymenga AB (2004) Distal tuberosity osteotomy in open wedge high tibial osteotomy can prevent patella infera: a new technique. Knee 11:457–461CrossRef
9.
Goshima K, Sawaguchi T, Shigemoto K, Iwai S, Nakanishi A, Ueoka K (2017) Patellofemoral osteoarthritis progression and alignment changes after open-wedge high tibial osteotomy do not affect clinical outcomes at mid-term follow-up. Arthroscopy 33:1832–1839CrossRef
10.
11.
Kim KI, Kim DK, Song SJ, Lee SH, Bae DK (2017) Medial open-wedge high tibial osteotomy may adversely affect the patellofemoral joint. Arthroscopy 33:811–816CrossRef
12.
Kloos F, Becher C, Fleischer B, Feucht MJ, Hohloch L, Südkamp N, Niemeyer P, Bode G (2019) High tibial osteotomy increases patellofemoral pressure if adverted proximal, while open-wedge HTO with distal biplanar osteotomy discharges the patellofemoral joint: different open-wedge high tibial osteotomies compared to an extra-articular unloading device. Knee Surg Sports Traumatol Arthrosc 27:2334–2344CrossRef
13.
Krause M, Drenck TC, Korthaus A, Preiss A, Frosch KH, Akoto R (2018) Patella height is not altered by descending medial open-wedge high tibial osteotomy (HTO) compared to ascending HTO. Knee Surg Sports Traumatol Arthrosc 26:1859–1866CrossRef
14.
Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11:132–138CrossRef
15.
Longino PD, Brimingham TB, Schultz WJ, Moyer RF, Giffin JR (2013) Combined tibial tubercle osteotomy with medial opening wedge high tibial osteotomy minimizes changes in patellar height: a prospective cohort study with historical controls. Am J Sports Med 41:2849–2857CrossRef
16.
17.
Pape D, Dueck K, Haag M, Lorbach O, Seil R, Madry H (2013) Wedge volume and osteotomy surface depend on surgical technique for high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 21:127–133CrossRef
18.
Saito T, Kumagai K, Akamatsu Y, Kobayashi H, Kusayama Y (2014) Five-to ten-year outcome following medial opening-wedge high tibial osteotomy with rigid plate fixation in combination with an artificial bone substitute. J Bone Joint Surg 96:339–344CrossRef
19.
Shim JS, Lee SH, Jung HJ, Lee HI (2013) High tibial open wedge osteotomy below the tibial tubercle: clinical and radiographic results. Knee Surg Sports Traumatol Arthrosc 21:57–63CrossRef
20.
Staubli AE, Simoni CD, Babst R, Lobenhoffer P (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia–early results in 92 cases. Injury 34:B55–B62CrossRef
21.
Tanaka T, Matsushita T, Miyaji N, Ibaraki K, Nishida K, Oka S, Araki D, Kanzaki N, Hoshino Y, Matsumoto T, Kuroda R (2019) Deterioration of patellofemoral cartilage status after medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 27:1347–1354CrossRef
22.
Tigani D, Ferrari D, Trentani P, Barbanti-Brodano G, Trentani F (2001) Patellar height after high tibial osteotomy. Int Orthop 24:331–334CrossRef
23.
van Heerwaarden R, Najfeld M, Brinkman M, Seil R, Madry H, Pape D (2013) Wedge volume and osteotomy surface depend on surgical technique for distal femoral osteotomy. Knee Surg Sports Traumatol Arthrosc 21:206–212CrossRef
24.
Zhim F, Laflamme GY, Viens H, Yahia L, Laflamme GH (2006) Biomechanical stability of a retrotubercle opening wedge high tibial osteotomy. J Knee Surg 19:28–32CrossRef
Metadaten
Titel
Increased contact area of flange and decreased wedge volume of osteotomy site by open wedge distal tibial tuberosity arc osteotomy compared to the conventional technique
verfasst von
Shuntaro Nejima
Ken Kumagai
Hiroshi Fujimaki
Shunsuke Yamada
Masaichi Sotozawa
Joji Matsubara
Yutaka Inaba
Publikationsdatum
28.09.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2021
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-020-06296-8

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