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18.09.2021 | Original Paper

Double level knee osteotomy using patient-specific cutting guides is accurate and provides satisfactory clinical results: a prospective analysis of a cohort of twenty-two continuous patients

verfasst von: Francesco Grasso, Pierre Martz, Grégoire Micicoi, Raghbir Khakha, Kristian Kley, Lukas Hanak, Matthieu Ollivier, Christophe Jacquet

Erschienen in: International Orthopaedics | Ausgabe 3/2022

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Abstract

Purpose

Double level osteotomy (DLO) (femoral and tibial) is a technically demanding procedure for which pre-operative planning accuracy and intraoperative correction are key factors. The aim of this study was to assess the accuracy of the achieved correction using patient-specific cutting guides (PSCGs) compared to the planned correction, its ability to maintain joint line obliquity (JLO), and to evaluate clinical outcomes and level of patient satisfaction at a follow-up of two years.

Methods

A single-centre, prospective observational study including 22 patients who underwent DLO by PSCGs between 2014 and 2018 was performed. Post-operative alignment was evaluated and compared with the target angular values to define the accuracy of the correction for the hip-knee-ankle angle (ΔHKA), medial proximal tibial angle (ΔMPTA), lateral distal femoral angle (ΔLDFA), and posterior proximal tibial angle (ΔPPTA). Pre- and post-operative JLO was also evaluated. At two year follow-up, changes in the KOOS sub-scores and patient satisfaction were recorded. The Mann–Whitney U test with 95% confidence interval (95% CI) was used to evaluate the differences between two variables; the paired Student’s t test was used to estimate evolution of functional outcomes.

Results

The mean ΔHKA was 1.3 ± 0.5°; the mean ΔMPTA was 0.98 ± 0.3°; the mean ΔLDFA was 0.94 ± 0.2°; ΔPPTA was 0.45 ± 0.4°. The orientation of the joint line was preserved with a mean difference in the JLO of 0.4 ± 0.2. At last follow-up, it was recorded a significant improvement in all KOOS scores, and 19 patients were enthusiastic, two satisfied, and one moderately satisfied.

Conclusion

Performing a DLO using PSCGs produces an accurate correction, without modification of the joint line orientation and with good functional outcomes at two year follow-up

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Titel: Double level knee osteotomy using patient-specific cutting guides is accurate and provides satisfactory clinical results: a prospective analysis of a cohort of twenty-two continuous patients
verfasst von: Francesco Grasso
Pierre Martz
Grégoire Micicoi
Raghbir Khakha
Kristian Kley
Lukas Hanak
Matthieu Ollivier
Christophe Jacquet
Publikationsdatum: 18.09.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 3/2022
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-05194-z

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Double level knee osteotomy using patient-specific cutting guides is accurate and provides satisfactory clinical results: a prospective analysis of a cohort of twenty-two continuous patients