Influence of hindfoot alignment on postoperative lower limb alignment in medial opening wedge high tibial osteotomy

2021 ◽  
Author(s):  
Kotaro Miyazaki ◽  
Akira Maeyama ◽  
Ichiro Yoshimura ◽  
Tomohiro Kobayashi ◽  
Tetsuro Ishimatsu ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Lower Limb ◽  
Tibial Osteotomy ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Opening Wedge ◽  
Hindfoot Alignment ◽  
Wedge High Tibial Osteotomy

scholarly journals Severe varus knees result in a high rate of undercorrection of lower limb alignment after opening wedge high tibial osteotomy

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901984666 ◽  
Author(s):  
Satoshi Kamada ◽  
Etsuji Shiota ◽  
Kazuhiko Saeki ◽  
Takahiko Kiyama ◽  
Akira Maeyama ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Lower Limb ◽  
High Rate ◽  
Tibial Osteotomy ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy

Ankle and Hindfoot Symptoms after Medial Open Wedge High Tibial Osteotomy

2018 ◽  
Vol 32 (03) ◽  
pp. 269-273 ◽  
Author(s):  
Jason Roberts ◽  
Frederic Picard ◽  
Siddharth Shah
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Postoperative Change ◽  
Radiological Indices ◽  
Wedge High Tibial Osteotomy ◽  
The Mean ◽  
New Onset

AbstractMedial open wedge high tibial osteotomy (MOWHTO) is a commonly performed procedure for symptomatic medial compartment osteoarthritis (OA). However, little is known about its effects on ipsilateral ankle or hindfoot. The aim of our study was to determine the incidence of ankle or hindfoot problems after MOWHTO and examine its association with radiological indices. Thirty-five knees (32 patients) undergoing navigated MOWHTO were evaluated for the presence of new-onset ankle or hindfoot symptoms after surgery. Pre- and postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and tibial plafond inclination (TPI) were measured and compared on standing lower limb alignment radiographs. The mean postoperative change in HKA angle, MPTA, and TPI was 8.8°, 7.0°, and 8.4°, respectively. New-onset unexplained ankle or hindfoot symptoms were seen in 20% of the cases after surgery. Postoperative change in TPI was significantly greater in symptomatic patients as compared with asymptomatic ones (12.8° ± 4.9° vs. 8.1° ± 4.8°, p = 0.03). The odds ratio (OR) for developing ankle or hindfoot symptoms in cases with ≥ 10° change in TPI postoperatively was 10.8 (p = 0.04). Ankle or hindfoot symptoms were successfully managed with conservative treatment in all cases.

Feasibility and 3D Planning of a Novel Patient-Specific Instrumentation Technique in Medial Opening-Wedge High Tibial Osteotomy

2020 ◽  
Author(s):  
Wouter Van Genechten ◽  
Wouter Van Tilborg ◽  
Maxim Van den Bempt ◽  
Annemieke Van Haver ◽  
Peter Verdonk
Keyword(s):  
High Tibial Osteotomy ◽  
Lower Limb ◽  
Strong Correlation ◽  
Intraoperative Complications ◽  
Patient Specific ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Patient Specific Instrumentation ◽  
Novel Approach ◽  
Wedge High Tibial Osteotomy

AbstractA novel approach for opening-wedge high tibial osteotomy (OWHTO) with patient-specific instrumentation (PSI) was evaluated for its safety, feasibility, and accuracy. Next, the mechanical medial proximal tibial angle (mMPTA) was assessed as a potential planning angle by investigating the relation with the mechanical femorotibial angle (mFTA). Ten OWHTO cases were 3D planned using the mMPTA and operated with a customized 3D-printed wedge and cast which resembled the intended osteotomy opening. Patients were closely monitored for intraoperative and postoperative complications up to 1 year after surgery. Radiological assessment was conducted on full leg standing radiographs and supine lower limb computed tomography-scans preoperatively and 3 months after surgery. No intraoperative complications or logistical issues during PSI processing were observed. Absolute accuracy outcomes showed a correction error of 1.3° ± 1.1 mMPTA and 0.9° ± 0.6 mFTA with all osteotomies falling in (−2°; + 2°) mFTA around the target. The mMPTA and mFTA were found to have a strong correlation in both 3D (r = 0.842, p = 0.002) and 2D (r = 0.766, p = 0.01) imaging for effective correction. The study confirmed the development of a safe and feasible PSI technique in OWHTO with excellent accuracy outcomes. The strong correlation between the mMPTA and mFTA indicated that soft tissue changes after OWHTO are of minor significance to the final alignment in ligament-stable patients. Finally, the mMPTA was found to be a reliable planning angle in 3D software for obtaining the intended lower limb realignment and its use can therefore be recommended in modern OWHTO planning.

A predictive factor for acquiring an ideal lower limb realignment after opening-wedge high tibial osteotomy

2009 ◽  
Vol 17 (4) ◽  
pp. 382-389 ◽  
Author(s):  
Haruhiko Bito ◽  
Ryohei Takeuchi ◽  
Ken Kumagai ◽  
Masato Aratake ◽  
Izumi Saito ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Predictive Factor ◽  
Lower Limb ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy
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