Journal article
Minimizing alteration of posterior tibial slope during opening wedge high tibial osteotomy: a protocol with experimental validation in paired cadaveric knees
The Iowa orthopaedic journal, Vol.34, pp.16-23
2014
PMCID: PMC4127712
PMID: 25328454
Appears in Diamond Open Access
Abstract
The High Tibial Osteotomy (HTO) is a reliable procedure in addressing uni- compartmental arthritis with associated coronal deformities. With osteotomy of the proximal tibia, there is a risk of altering the tibial slope in the sagittal plane. Surgical techniques continue to evolve with trends towards procedure reproducibility and simplification. We evaluated a modification of the Arthrex iBalance technique in 18 paired cadaveric knees with the goals of maintaining sagittal slope, increasing procedure efficiency, and decreasing use of intraoperative fluoroscopy.
Nine paired cadaveric knees (18 legs) underwent iBalance medial opening wedge high tibial osteotomies. In each pair, the right knee underwent an HTO using the modified technique, while all left knees underwent the traditional technique. Independent observers evaluated postoperative factors including tibial slope, placement of hinge pin, and implant placement. Specimens were then dissected to evaluate for any gross muscle, nerve or vessel injury.
Changes to posterior tibial slope were similar using each technique. The change in slope in traditional iBalance technique was -0.3° ±2.3° and change in tibial slope using the modified iBalance technique was -0.4° ±2.3° (p=0.29). Furthermore, we detected no differences in posterior tibial slope between preoperative and postoperative specimens (p=0.74 traditional, p=0.75 modified). No differences in implant placement were detected between traditional and modified techniques. (p=0.85). No intraoperative iatrogenic complications (i.e. lateral cortex fracture, blood vessel or nerve injury) were observed in either group after gross dissection.
Alterations in posterior tibial slope are associated with HTOs. Both traditional and modified iBalance techniques appear reliable in coronal plane corrections without changing posterior tibial slope. The present modification of the Arthrex iBalance technique may increase the efficiency of the operation and decrease radiation exposure to patients without compromising implant placement or global knee alignment.
Details
- Title: Subtitle
- Minimizing alteration of posterior tibial slope during opening wedge high tibial osteotomy: a protocol with experimental validation in paired cadaveric knees
- Creators
- Robert W Westermann - University of Iowa Hospitals and Clinics Department of Orthopaedics and RehabilitationThomas DeBerardino - New England Musculoskeletal Institute UConn Health CenterAnnunziato Amendola - University of Iowa Hospitals and Clinics Department of Orthopaedics and Rehabilitation
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.34, pp.16-23
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 25328454
- PMCID
- PMC4127712
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 2014
- Academic Unit
- Orthopedics and Rehabilitation; Athletic Training Program
- Record Identifier
- 9984040561802771
Metrics
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