Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees

Agneskirchner, Jens D.; Hurschler, Christof; Stukenborg-Colsman, Christina; Imhoff, Andreas B.; Lobenhoffer, Philipp

doi:10.1007/s00402-004-0728-8

Cited by 308 publications

(281 citation statements)

References 12 publications

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“…The contact pressure at the cartilage surface was 4.2 MPa (Fig. 2d), which is in range of the reported data in the literature (Mononen et al 2011;Agneskirchner et al 2004;Meyer et al 2008;Marzo and Gurske-DePerio 2009;Morimoto et al 2009). …”

Section: Native Tissue Without Implantsupporting

confidence: 86%

The effect of tissue-engineered cartilage biomechanical and biochemical properties on its post-implantation mechanical behavior

Khoshgoftar

Wilson

Ito

et al. 2012

Biomech Model Mechanobiol

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The insufficient load-bearing capacity of today's tissue-engineered (TE) cartilage limits its clinical application. Focus has been on engineering cartilage with enhanced mechanical stiffness by reproducing native biochemical compositions. More recently, depth dependency of the biochemical content and the collagen network architecture has gained interest. However, it is unknown whether the mechanical performance of TE cartilage would benefit more from higher content of biochemical compositions or from achieving an appropriate collagen organization. Furthermore, the relative synthesis rate of collagen and proteoglycans during the TE process may affect implant performance. Such insights would assist tissue engineers to focus on those aspects that are most important. The aim of the present study is therefore to elucidate the relative importance of implant ground substance stiffness, collagen content, and collagen architecture of the implant, as well as the synthesis rate of the biochemical constituents for the post-implantation mechanical behavior of the implant. We approach this by computing the post-implantation mechanical conditions using a composition-based fibril-reinforced poro-viscoelastic swelling model of the medial tibia plateau. Results show that adverse implant composition and ultrastructure may lead to post-implantation excessive mechanical loads, with collagen orientation being

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Section: Native Tissue Without Implantsupporting

confidence: 86%

The effect of tissue-engineered cartilage biomechanical and biochemical properties on its post-implantation mechanical behavior

Khoshgoftar

Wilson

Ito

et al. 2012

Biomech Model Mechanobiol

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“…Dejour and Bonnin reported for every 10°increase in PTS there is an anterior tibial shift of 6 mm in a monopedal stance test [13]. An experimental PTS increase (5°-20°) resulted in anterior (2.1 mm-4.6 mm) and superior (1.6 mm-4.1 mm) translation of the tibial plateau with respect to the femoral condyles [1]. Some authors presumed that with greater translation greater ligament loading occurred and placed the ACL at greater risk with an increased PTS [13,17,44].…”

Section: Introductionmentioning

confidence: 92%

“…It is defined by a tangent line to the respective tibial plateau and a line perpendicular to the longitudinal axis (LA) of the tibial bone that averages 10°(± 3°) on radiographs [9,13,16,19]. The measure reportedly influences knee kinematics [1,17] and ligament function [41,42,44]. Dejour and Bonnin reported for every 10°increase in PTS there is an anterior tibial shift of 6 mm in a monopedal stance test [13].…”

Section: Introductionmentioning

confidence: 99%

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Hudek

Fuchs

Regenfelder

et al. 2011

Clinical Orthopaedics &Amp; Related Research

128

167

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Background The risk of noncontact ACL injury reportedly is increased in patients with a greater posterior tibial slope (PTS), but clinical data are inconsistent. It is unclear whether the medial and lateral PTSs have a different impact on this connection. It also is unknown whether the meniscal slope (MS) is associated with ACL injury. Patients/methods Using MRI, we compared the medial and lateral PTSs and MSs separately in 55 matched pairs of patients with isolated noncontact ACL injuries and a control group.

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“…37 This decompression has been proposed as a possible treatment option for posterior cartilage damage. 37 However, no studies have shown the in vivo consequences of anterior contact pressure shifts on cartilage.…”

Section: Se = Standard Errormentioning

confidence: 99%

Measurement of tibial slope angle after medial opening wedge high tibial osteotomy: case series

et al. 2009

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CONTEXT AND OBJECTIVE: In the past, changes in tibial slope were not considered when planning or evaluating osteotomies, and success in high tibial osteotomy was related to the alignment and amount of femorotibial angular correction. The aim here was to measure changes in tibial slope after medial opening wedge tibial osteotomy and investigate the effect of tibial slope angle on the clinical results. DESIGN AND SETTING:Retrospective review study on a series of cases, at the Department of Orthopedics and Traumatology, Faculdade de Medicina de Marília (Famema), Marília, Brazil. METHODS:Twenty-eight patients were studied, and a total of thirty-one knees. Lateral roentgenograms of the tibia were used pre and postoperatively to measure the tibial slope based on the proximal tibial anatomical axis. The clinical results were measured using the Lysholm knee score. RESULTS:There was an average increase in tibial slope angle after surgery of 2.38° (95% confidence interval: ± 0.73°). There was no correlation (r = -0.28) between the postoperative Lysholm knee score and the difference in tibial slope angle from before to after surgery (P = 0.13).CONCLUSION: Medial opening wedge tibial osteotomy led to a small increase in tibial slope. No significant correlation was found between increased tibial slope and short-term clinical results after high tibial osteotomy. Other clinical studies are needed in order to establish whether extension or flexion osteotomy could benefit patients with medial compartment gonarthrosis. RESUMO CONTEXTO E OBJETIVO:No passado, alterações no ângulo de inclinação ântero-posterior do planalto tibial (AIAPPT), conhecido como "slope", não eram levadas em consideração no planejamento e avaliação das osteotomias, e o sucesso da osteotomia proximal tibial era relacionado ao grau de correção do ângulo femoro-tibial e ao alinhamento obtido. O objetivo foi mensurar a alteração no AIAPPT após a osteotomia proximal de abertura de cunha medial da tíbia e verificar o efeito da variação angular do AIAPPT sobre os resultados clínicos. TIPO DE ESTUDO E LOCAL: MÉTODOS:Foram incluídos 28 pacientes, e um total de 31 joelhos. Foi mensurado o AIAPPT baseado no eixo anatômico proximal tibial na radiografia lateral da tíbia no pré e no pós-operatório. A avaliação clínica foi realizada através do escore de Lysholm para joelho. RESULTADOS:Houve um aumento do AIAPPT após a cirurgia em média de 2,38° (± 0,73°; intervalo de confiança, IC 95%). Não houve correlação (r = -0,28) entre os resultados obtidos pelo escore de Lysholm pós-operatório e a diferença do AIAPPT pós e pré-operatório (P = 0,13).CONCLUSÃO: A osteotomia valgizante da tíbia proximal com cunha de abertura medial levou a um pequeno aumento no AIAPPT. Não houve correlação entre o aumento do slope tibial e os resultados clínicos a curto prazo após a osteotomia proximal da tíbia. Outros estudos clínicos são necessários para comprovar se uma osteotomia de extensão ou de flexão pode trazer benefício ao paciente com artrose unicompartimental do joelho.

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Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees

Cited by 308 publications

References 12 publications

The effect of tissue-engineered cartilage biomechanical and biochemical properties on its post-implantation mechanical behavior

The effect of tissue-engineered cartilage biomechanical and biochemical properties on its post-implantation mechanical behavior

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Measurement of tibial slope angle after medial opening wedge high tibial osteotomy: case series

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