Advances in modern osteotomies around the knee

Gao, Liang; Madry, Henning; Чугаев, Д. В.; Denti, Matteo; Фролов, А. В.; Burtsev, M. E.; Magnitskaya, N. E.; Mukhanov, Victor; Neyret, Philippe; Соломин, Леонид Николаевич; Сорокин, Е. П.; Staubli, Alex E; Stone, Kevin R.; Vilenskiy, Viktor; Zayats, Vitaliy; Pape, Dietrich; Korolev, A. V.

doi:10.1186/s40634-019-0177-5

Cited by 44 publications

(22 citation statements)

References 111 publications

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“…As such, great consensus exists between orthopaedic surgeons to aim for a slightly postoperative valgus alignment of the knee. Many authors suggest a postoperative femorotibial valgus angle of 5-10° which equates the intersection of the weightbearing line at 62-66% of the tibial width [21][22][23][24][25]. The ideal correction angle is believed to allow for a su cient unloading and regeneration of the medial compartment while at the same time avoiding an overloading and degeneration of the lateral compartment [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Focal Cartilage Defects of the Lateral Compartment do Influence the Outcome After High Tibial Valgus Osteotomy

Heinz

Reppenhagen

Horas

et al. 2020

Preprint

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BackgroundHigh tibial medial open-wedge valgus osteotomy (HTO) is a well-established procedure for unicompartimental medial osteoarthritis of the young and active patient. The aim of this study was to evaluate the influence of asymptomatic mild to moderate cartilage lesions of the lateral tibiofemoral compartment on the clinical outcome after HTO. MethodsFrom 2005 to 2012 a total of 63 patients underwent HTO for medial osteoarthritis of the knee at a single university orthopaedic center. Baseline data as well as intraoperative findings including the grade and location of cartilage lesions were evaluated retrospectively. Two groups were formed regarding the integrity of the lateral tibiofemoral compartment as measured by the Outerbridge score (group A: no lateral cartilage defects, group B: mild to moderate lateral cartilage defects). Functional outcome was assessed using the Knee and Osteoarthritis Outcome Score (KOOS) including its five subscores. ResultsComparing pre- and postoperative data, we identified an overall benefit of the HTO procedure as measured by the KOOS. Group A (no lateral cartilage defects) showed an increase in all five KOOS subscores (p=0.00 – 0.01), whereas for group B (mild to moderate lateral cartilage defects) only two KOOS subscores revealed a significant increase (p=0.03 – 0.04). There was also a statistically significant difference of the total KOOS score with higher values for group A at the postoperative visit. Cartilage defects with a higher Outerbridge score were associated with lower postoperative KOOS subscores. ConclusionsMild to moderate cartilage defects of the lateral compartment humble the total outcome after HTO procedure. Thus, indication for HTO should be made very carefully, if any degree of lateral cartilage degeneration is present.

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Section: Discussionmentioning

confidence: 99%

Focal Cartilage Defects of the Lateral Compartment do Influence the Outcome After High Tibial Valgus Osteotomy

Heinz

Reppenhagen

Horas

et al. 2020

Preprint

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“…The CAOS systems also have an ambition to be used as a system with a minimal invasiveness in the tissue engineering on the artificial cartilage replacement. In this operation, the CAOS systems can control the tissue shape [263,264,265,266,267,268].…”

Section: Discussion and Future Perspectivesmentioning

confidence: 99%

Recent Trends, Technical Concepts and Components of Computer-Assisted Orthopedic Surgery Systems: A Comprehensive Review

Kubíček

Tomanec

Černý

et al. 2019

Sensors

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Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.

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“…Such assessment tools can be especially useful in younger patient populations undergoing lower limb surgery where functional recovery is of much importance. There is a growing demand of corrective lower limb surgical procedures in patients that are young and physically active due to various reasons including early stage osteoarthritis causing mild deformities and pain, and limb lengthening for leg length discrepancy or idiopathic short stature [ 14 , 15 ]. These patients have a wide range of expectations encompassing pain relief, physical ability, and psychological well-being [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Inhalational versus intravenous maintenance of anesthesia for quality of recovery in patients undergoing corrective lower limb osteotomy: A randomized controlled trial

Kim

Choi

et al. 2021

PLoS ONE

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Background Inhalational anesthesia and propofol-based total intravenous anesthesia (TIVA) are the two most popular methods of general anesthesia with distinct characteristics that may affect quality of recovery (QOR) differently. This study compared QOR after corrective lower limb osteotomy between desflurane-based inhalational anesthesia and propofol-based TIVA. Methods Sixty-eight patients, ASA class I or II who underwent corrective lower limb osteotomy were randomized to receive either desflurane anesthesia or propofol TIVA. The primary outcome was quality of recovery 40 (QoR-40) questionnaire scores on postoperative day (POD) 1 and 2. Postoperative nausea scores, antiemetic requirements, and amount of opioid consumption via intravenous patient-controlled analgesia (IV PCA) were assessed as secondary outcomes. Results Global QoR-40 scores on POD 1 (153.5 (140.3, 171.3) vs. 140.0 (120.0, 173.0), P = 0.056, 95% CI; -22.5, 0.2) and POD 2 (155.5 (146.8, 175.5) vs. 152.0 (134.0, 179.0), P = 0.209, 95% CI; -17.5, 3.9) were comparable between the two groups. Among the five dimensions of QoR-40, physical independence scores were significantly higher in the TIVA group compared to the Desflurane group on POD both 1 and 2. Nausea scores (0.0 (0.0, 0.0) vs. 1.0 (0.0, 3.5), P < 0.001) and number of patients requiring rescue antiemetics (0% vs. 15.2%, P = 0.017) were significantly lower in the TIVA group at the post anesthesia care unit (PACU). Although the number of bolus attempts between 0–24 h and the morphine equivalent dose of analgesics administered via IV PCA between 12–24 h were significantly less in the TIVA group compared to the Desflurane group, there was no significant difference between groups for the overall 48 h postoperative period. Conclusions Propofol-based TIVA did not improve global QoR-40 scores compared with desflurane-based inhalational anesthesia. However, considering the better QoR-40 scores in the domain of physical independence and less nausea in the early postoperative period, propofol TIVA should be considered as a useful option in patients undergoing corrective lower limb osteotomy.

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Advances in modern osteotomies around the knee

Cited by 44 publications

References 111 publications

Focal Cartilage Defects of the Lateral Compartment do Influence the Outcome After High Tibial Valgus Osteotomy

Focal Cartilage Defects of the Lateral Compartment do Influence the Outcome After High Tibial Valgus Osteotomy

Recent Trends, Technical Concepts and Components of Computer-Assisted Orthopedic Surgery Systems: A Comprehensive Review

Inhalational versus intravenous maintenance of anesthesia for quality of recovery in patients undergoing corrective lower limb osteotomy: A randomized controlled trial

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