High reliability in digital planning of medial opening wedge high tibial osteotomy, using Miniaci’s method

Elson, David W.; Petheram, Timothy; Dawson, Matt

doi:10.1007/s00167-014-2920-x

Cited by 96 publications

(88 citation statements)

References 36 publications

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“…All osteotomies were performed by one senior orthopedist (Y.R.Z.). Preoperative planning (correction angle and amount of opening gap) was determined as previous described by using the Fujisawa point and Miniaci method [21][22][23] .…”

Section: Surgical Proceduresmentioning

confidence: 99%

Effect of the Amount of Correction on Posterior Tibial Slope and Patellar Height in Open-wedge High Tibial Osteotomy

zeng

et al. 2020

Preprint

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Objectives The effect of amount of correction on postoperative changes in the posterior tibial slope (PTS), patellar height (PH) and clinical outcomes following biplanar open-wedge high tibial osteotomy (OWHTO) were evaluated. Method This study included 64 knees (30 left, 34 right) of 64 patients (mean age 48.5±6.8 years, 20 males, 44 females) with varus malalignment and symptomatic isolated medial joint osteoarthritis who underwent OWHTO. According to the amount of correction angles, all patients were divided into three groups: large correction angle (LCA) group (>14°), medium correction angle (MCA) group（10°～14°）and small correction angle (SCA) group (<10°). All patients were clinically assessed according to the Lysholm score, hospital for special surgery knee score (HSS), and knee society score (KSS) prior to and after surgery. For radiographic analysis, we measured the PTS，PH [Insall-Salvati index (ISI), Blackbume-Peel index (BPI)]. The pre-post difference of PTS, ISI and BPI was calculated by subtracting the post-OWHTO value to the pre-OWHTO value in three groups respectively. The preoperative, postoperative, and difference of PTS, ISI and BPI values were analyzed according to the correction angle. The mean follow-up period was 27.7 months(SD, 3.9; range 12-49 months). Results Radiologically, PTS increased and PH decreased after surgery on the whole ( p ＜0.05). The relationship between amount of correction and slope increasing is significant ( p ＜0.001). Furthermore, the pairwise difference between the LCA group and SCA group, MCA group are significant respectively ( p ＜0.05). In terms of PH, the LCA group yielded ISI and BPI that were significantly different from baseline for SCA group and MCA group. In addition, the pairwise difference between the SCA group and LCA group in ISI and BPI are significant ( p =0.031). Clinically, significant improvements were observed in postoperative clinical scores of the Lysholm score, HSS, and KSS ( p <0.05). Fifty-nine patients (92.2%) reported satisfaction with surgery. However, no correlation was found between changes in PTS and PH with postoperative knee score. No severe adverse complications were observed. Conclusions The amount of correction angle is a significant factor affecting the PTS and PH in OWHTO. With increased correction angle, the likelihood of increasing the PTS and decreasing the PH increases. Special attention should be paid to keep PTS and PH unchanged in cases where large corrections are required. Otherwise, closing wedge osteotomy or other intraoperative effective measures are supposed to be adopted.

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Section: Surgical Proceduresmentioning

confidence: 99%

Effect of the Amount of Correction on Posterior Tibial Slope and Patellar Height in Open-wedge High Tibial Osteotomy

zeng

et al. 2020

Preprint

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“…Preoperative planning was performed according to the "Miniaci's method" and proper gap diameter was measured with the patient standing in the whole lower extremity anteroposterior view. 8,9 After spinal anesthesia, the tourniquet was inflated to 350 mm Hg and a routine arthroscopic examination was done using anteromedial and anterolateral portals. If necessary, arthroscopic procedures, such as meniscectomy, meniscal repair, debridement, and/or microfracture chondroplasty, were done.…”

Section: Surgical Procedures and Topical Tranexamic Acid Administrationmentioning

confidence: 99%

Efficacy of Tranexamic Acid for Hemostasis in Patients Undergoing High Tibial Osteotomy

et al. 2017

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Extensive bone bleeding and an uncomfortable hematoma can develop due to the opening gap and space during a medial open high tibial osteotomy (HTO). Tranexamic acid (TXA) has been used in various orthopaedic surgeries to reduce bleeding and wound complications. However, no study has investigated the effect of TXA during HTO. Therefore, the purpose of this study is to evaluate the efficacy of TXA in reducing postoperative blood loss in patients undergoing HTO. The hypothesis is that topical TXA administration will reduce postoperative bleeding in patients undergoing medial opening HTO. Topical TXA (2 g in 20 mL saline) was administered at the osteotomy site in patients ( = 15) who underwent medial open HTO from November 2015 to March 2016. Patients ( = 15) who underwent medial open wedge HTO by the same surgeon from October 2014 to October 2015 were enrolled as a control group for comparison. Drainage volumes on postoperative days (PODs) 1, 2, and 3 as well as hemoglobin (Hb) level on PODs 1, 6, and 13 were measured and compared. Mean total postoperative drainage volume was 246 mL in the TXA group and 377 mL in the control group. Mean drainage volume on POD 1 was 138 mL in the TXA group and 277 mL in the control group ( < 0.05). No differences in drainage volume were detected between the groups on POD 2 or 3. Preoperative Hb levels were 13.0 g/dL in the TXA group and 12.9 g/dL in the control group, which decreased to 11.9 g/dL in the TXA group and 11.2 g/dL in the control group on POD 1. These postoperative Hb differences were significant ( < 0.05). Also, Hb levels were 11.7 and 12.0 g/dL in the TXA group and 11.4 and 11.6 g/dL in the control group on PODs 6 and 13, respectively ( > 0.05). An extensive hematoma requiring additional surgery developed in one case in the control group. No wound complications were detected in the TXA group. Topical TXA was effective for reducing postoperative bleeding after medial open HTO. The level of evidence of the study is Level 3.

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“…Pre-operative planning is mandatory in osteotomy surgery (Elson et al, 2014) and this was performed to generate a simulated correction angle (Dugdale et al, 1992) and opening distance (Hernigou, 2002). Medial opening wedge HTO was performed (Lobenhoffer and Agneskirchner, 2003) to generate the planned opening distance before fixation with the TomoFix plate device (Depuy Synthes, Solothurn, Switzerland).…”

Section: Surgerymentioning

confidence: 99%

“…Medial opening wedge HTO was performed (Lobenhoffer and Agneskirchner, 2003) to generate the planned opening distance before fixation with the TomoFix plate device (Depuy Synthes, Solothurn, Switzerland). Achieved correction was judged from post-operative long leg alignment radiographs by measuring the mechanical tibiofemoral angle (Paley et al, 1994) and the transection point of the weight bearing axis through the tibial plateau, expressed as a percentage of the tibial width from medial to lateral (Elson et al, 2014). Patients completed the Oxford knee score (Dawson et al, 1998).…”

Section: Surgerymentioning

confidence: 99%

Combined effect of toe out gait and high tibial osteotomy on knee adduction moment in patients with varus knee deformity

Whelton

Thomas

Elson

et al. 2017

Clinical Biomechanics

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Increasing the foot progression angle from 20° (natural) to 30° in isolation did not significantly alter the knee adduction moment or angular impulse. This suggests that adopting a toe out gait, in isolation, in an already high natural foot progression angle, is not of benefit. Adopting toe out gait post-operatively, however, resulted in a further reduction in the second peak to below that of the healthy control cohort, however, this may increase lateral compartment load.

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High reliability in digital planning of medial opening wedge high tibial osteotomy, using Miniaci’s method

Abstract: Diagnostic study, Level II.

Cited by 96 publications

References 36 publications

Effect of the Amount of Correction on Posterior Tibial Slope and Patellar Height in Open-wedge High Tibial Osteotomy

Effect of the Amount of Correction on Posterior Tibial Slope and Patellar Height in Open-wedge High Tibial Osteotomy

Efficacy of Tranexamic Acid for Hemostasis in Patients Undergoing High Tibial Osteotomy

Combined effect of toe out gait and high tibial osteotomy on knee adduction moment in patients with varus knee deformity

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