In-toeing gait in children with clubfoot and the effect of tibial rotation osteotomy

2019 ◽  
Vol 29 (4) ◽  
pp. 348-354
Author(s):  
David E. Westberry ◽  
Roy B. Davis ◽  
Rachel Binkley-Vance ◽  
Andrew Westberry ◽  
Alison Westberry ◽  
...  
Keyword(s):  
Tibial Rotation ◽  
Rotation Osteotomy

scholarly journals Supracondylar rotation osteotomy of the femur influences the coronal alignment of the ankle

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Christian Konrads ◽  
Marc-Daniel Ahrend ◽  
Myriam R. Beyer ◽  
Ulrich Stöckle ◽  
Sufian S. Ahmad
Keyword(s):  
Subtalar Joint ◽  
Distal Femur ◽  
External Rotation ◽  
Weight Bearing ◽  
Orientation Angle ◽  
Osteotomy Site ◽  
Limb Alignment ◽  
Coronal Alignment ◽  
Rotational Osteotomy ◽  
Rotation Osteotomy

Abstract Purpose Osteotomies represent well-established treatment-options for the redistribution of loads and forces within and around the knee-joint. Effects of these osteotomies on the remaining planes and adjacent joints are not fully understood. The aim of this study was to determine the influence of a distal-femoral-rotation-osteotomy on the coronal alignment of the ankle. It was hypothesized that supracondylar-external-rotation-osteotomy of the distal femur leads to a change in the coronal orientation of the ankle joint. Methods Long-leg standing radiographs and CT-based torsional measurements of 27 patients undergoing supracondylar-rotational-osteotomy of the femur between 2012 and 2019 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy-site. The hip-knee-ankle-angle (HKA), the mechanical-lateral-distal-femur-angle (mLDFA), and Tibia-Plafond-Horizontal-Orientation-Angle (TPHA) around the ankle were measured. Comparison between means was performed using the Wilcoxon-Mann–Whitney test. Results Twenty-seven patients with high femoral antetorsion (31.3° ± 4.0°) underwent supracondylar-external-rotation-osteotomy. The osteotomy led to a reduced antetorsion (17.4 ± 5.1; p < 0.001) and to a valgisation of the overall limb-alignment. The HKA decreased by 2.4° ± 1.4° (p < 0.001). The TPHA decreased by 2.6° (p < 0.001). Conclusions Supracondylar external rotation osteotomy of the femur leads to lateralization of the weight bearing line at the knee and ankle due to valgisation of the coronal limb alignment. The mobile subtalar joint has to compensate (inversion) for the resulting valgus orientation of the ankle to ensure contact between the foot and the floor. When planning a rotational osteotomy of the lower limb, this should be appreciated – especially in patients with a preexisting valgus alignment of the lower extremities or restricted mobility in the subtalar joint.

Adjusting Insert Thickness and Tibial Slope Do Not Correct Internal Tibial Rotation Loss Caused by PCL Resection: In Vitro Study of a Medial Constraint TKA Implanted with Unrestricted Calipered Kinematic Alignment

2021 ◽  
Author(s):  
Alexander J. Nedopil ◽  
Peter J. Thadani ◽  
Thomas H. McCoy ◽  
Stephen M. Howell ◽  
Maury L. Hull
Keyword(s):  
Internal Rotation ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Kinematic Alignment ◽  
Tibial Rotation ◽  
Medial Condyle ◽  
Maximum Extension ◽  
Posterior Tibial ◽  
Internal Tibial Rotation ◽  
Lift Off

AbstractMost medial stabilized (MS) total knee arthroplasty (TKA) implants recommend excision of the posterior cruciate ligament (PCL), which eliminates the ligament's tension effect on the tibia that drives tibial rotation and compromises passive internal tibial rotation in flexion. Whether increasing the insert thickness and reducing the posterior tibial slope corrects the loss of rotation without extension loss and undesirable anterior lift-off of the insert is unknown. In 10 fresh-frozen cadaveric knees, an MS design with a medial ball-in-socket (i.e., spherical joint) and lateral flat insert was implanted with unrestricted calipered kinematic alignment (KA) and PCL retention. Trial inserts with goniometric markings measured the internal–external orientation relative to the femoral component's medial condyle at maximum extension and 90 degrees of flexion. After PCL excision, these measurements were repeated with the same insert, a 1 mm thicker insert, and a 2- and 4-mm shim under the posterior tibial baseplate to reduce the tibial slope. Internal tibial rotation from maximum extension and 90 degrees of flexion was 15 degrees with PCL retention and 7 degrees with PCL excision (p < 0.000). With a 1 mm thicker insert, internal rotation was 8 degrees (p < 0.000), and four TKAs lost extension. With a 2 mm shim, internal rotation was 9 degrees (p = 0.001) and two TKAs lost extension. With a 4 mm shim, internal rotation was 10 degrees (p = 0.002) and five TKAs lost extension and three had anterior lift-off. The methods of inserting a 1 mm thicker insert and reducing the posterior slope did not correct the loss of internal tibial rotation after PCL excision and caused extension loss and anterior lift-off in several knees. PCL retention should be considered when using unrestricted calipered KA and implanting a medial ball-in-socket and lateral flat insert TKA design, so the progression of internal tibial rotation and coupled reduction in Q-angle throughout flexion matches the native knee, optimizing the retinacular ligaments' tension and patellofemoral tracking.

scholarly journals Posterior Tibial Subchondral Bone and Meniscal Slope Correlate with In Vivo Internal Tibial Rotation

2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0030
Author(s):  
Elmar Herbst ◽  
Tom Gale ◽  
Kanto Nagai ◽  
Yasutaka Tashiro ◽  
James J. Irrgang ◽  
...  
Keyword(s):  
Subchondral Bone ◽  
Tibial Rotation ◽  
Posterior Tibial ◽  
Internal Tibial Rotation

Location of the natural knee axis for internal–external tibial rotation

The Knee ◽  
2016 ◽  
Vol 23 (6) ◽  
pp. 1083-1088 ◽  
Author(s):  
Daniel V. Boguszewski ◽  
Nirav B. Joshi ◽  
Paul R. Yang ◽  
Keith L. Markolf ◽  
Frank A. Petrigliano ◽  
...  
Keyword(s):  
Tibial Rotation

Congenital Radio-Ulnar Synostosis: Compensatory Rotation around the Wrist and Rotation Osteotomy.

1987 ◽  
Vol 12 (2) ◽  
pp. 173-178
Author(s):  
T. OGINO ◽  
K. HIKINO
Keyword(s):  
Clinical Features ◽  
Daily Life ◽  
Functional Results ◽  
Rotational Osteotomy ◽  
Compensatory Movement ◽  
The Mean ◽  
Almost All ◽  
Rotation Osteotomy

In order to make clear the clinical features of congenital radio-ulnar synostosis, compensatory rotation around the wrist and functional results after rotation osteotomy, 40 cases of congenital radio-ulnar synostosis have been analysed. The mean pronation of the ankylosed forearm in those who complained of disabilities in daily life was 60.7° and that in patients without complaints was 21.2°. In almost all cases with total ankylosis, the forearm had compensatory movement around the wrist, the mean arc being from 76.3° of pronation to 42.9° of supination. 13 limbs in 11 patients treated by transverse rotational osteotomies through the fusion mass have followed up for over two years. The functional results after surgery were satisfactory in all patients. Rotational osteotomy of the forearm is a useful and reliable treatment for congenital radio-ulnar synostosis.

Ankle joint dorsi-plantar flexion and recurrence after femoral de-rotation osteotomy

2021 ◽  
Vol 90 ◽  
pp. 221-222
Author(s):  
F. Salami ◽  
M. Goetze ◽  
M. Thielen ◽  
S.I. Wolf
Keyword(s):  
Ankle Joint ◽  
Plantar Flexion ◽  
Rotation Osteotomy
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