Bildgebung und pr�operative Planung der Tibiakopfosteotomie

Abstract

Valgus-producing osteotomy of the proximal tibia is a well-established treatment for medial femorotibial osteoarthritis in the varus knee. The ideal patient is active, under 55 years of age, has a stable varus deformity of less than 10 degrees, a good bone stock, and an osteoarthritis stage that is restricted to the medial compartment of the knee. Coventry reported a failure rate in proximal tibial osteotomy to be significantly higher when the postoperative alignment was less than 8 degrees of anatomical valgus. Hernigou noted better clinical long-term results in cases with a precise correction of malalignment. There are different preoperative planning methods varying between simple estimates of correction angles and specific radiographic planning tools. The reproducibility of operative outcome with regard to a predictable anatomic alignment and functional recovery must have high priority. This chapter deals with different preoperative planning methods to improve the reliability of surgical results after tibial osteotomy.

Comparison of Cable Method and Miniaci Method Using Picture Archiving and Communication System in Preoperative Planning for Open Wedge High Tibial Osteotomy

“…Many authors have presented various pre-operative planning modalities12,17–19). Still, the radiopaque line is frequently employed for intraoperative guidance.…”

Mechanical strength assessment of a drilled hole in the contralateral cortex at the end of the open wedge for high tibial osteotomy

“…Precise preoperative planning (Pape et al 2004a, 2004b) and a high primary stability of the implant-bone-construct are required for a good result. An intact lateral cortical hinge is important for the stability of an opening wedge high tibial osteotomy (OWHTO) because fractures have been reported to cause loss of correction and poor clinical results (Agneskirchner et al 2006; Stoffel et al 2004; van Raaij et al 2008; Türkmen et al 2016; Jo et al 2017).…”

Predicting the knee adduction moment after high tibial osteotomy in patients with medial knee osteoarthritis using dynamic simulations

“…High tibial osteotomy (HTO) is a commonly used surgical procedure aiming at altering the load distribution in the tibiofemoral joint during ambulation in cases of medial knee osteoarthritis (OA) [1,2]. In order to correct a varus alignment, the weight-bearing axis is moved laterally, but, its ideal position is not known and the target correction angle is discussed controversially in the lit-erature [3][4][5][6]. Most methods currently used for planning a HTO calculate the position of the weight-bearing axis based on Fujisawa's work [7].…”