High tibial osteotomy: will new techniques provide better results?

Olin, Matthew D.; Vail, Thomas P.

doi:10.1097/00001433-200102000-00002

Cited by 4 publications

(6 citation statements)

References 26 publications

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Section: Methodsmentioning

confidence: 99%

“…Foi realizado o planejamento pré-operatório com a utilização de radiografias panorâmicas longas com análise dos eixos mecânico e anatômico, permitindo o cálculo do tamanho da cunha a ser executada, conforme o método descrito por Noyes e Dugdale. 24,25 A OTA foi realizada com o objetivo de se manter neutro o eixo de carga do membro inferior, associada à hipercorreção em torno de 2°a 5°de valgo, de modo que o eixo mecânico passe lateralmente ao centro da articulação do joelho, idealmente entre a porção média e lateral do côndilo lateral (62%), discretamente lateral à eminência intercondilar lateral. 3,24 Foram realizadas cunhas de abertura de até 15 mm, sendo que até 10 mm utilizou-se somente o espaçador da placa e de 10 a 15 mm foi acrescentado enxerto autólogo tricortical da crista ilíaca ipsilateral.…”

Section: Descrição Dos Procedimentosunclassified

“…Preoperative planning employed long panoramic radiographs, analyzing mechanical and anatomical axes to calculate the size of the required wedge according to the noyes and Dugdale method. 24,25 High tibial osteotomy was performed following the concept, in which the load axis of the lower limb is kept in a neutral position and an hypercorrection of $ 2°to 5°in valgus is performed; as such, the mechanical axis passes laterally to the center of the knee joint, ideally between the middle and lateral portion of the lateral condyle (62%), and slightly lateral to the lateral intercondylar eminence. 3,24 Opening wedges of up to 15 mm were made.…”

Section: Description Of the Proceduresmentioning

confidence: 99%

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Retorno ao esporte após osteotomia tibial alta com método de cunha de abertura

Nicolini

Christiano

Abdalla

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Avaliar o retorno ao esporte em pacientes jovens e ativos praticantes de alguma modalidade esportiva submetidos a osteotomia tibial alta (OTA) com o método de cunha de abertura. Métodos Foram analisados prospectivamente 12 pacientes submetidos ao procedimento de OTA utilizando-se método de cunha de abertura. Todos os pacientes estavam afastados do esporte. Foram utilizados os escores Lysholm, questionário International Knee Documentation Committee (IKDC, na sigla em inglês), escala analógica de dor e nível de retorno em comparação ao período pré-operatório. O tempo médio de seguimento foi de 12 meses. Resultados Um paciente retornou ao esporte em nível muito abaixo do pré-operatório, oito pacientes retornaram em nível pouco abaixo, dois pacientes retornaram no mesmo nível e um paciente retornou em nível acima. Conclusão A OTA com uso do método de cunha de adição como forma de tratamento para osteoartrose medial isolada demonstra resultados clínicos e funcionais favoráveis e permite o retorno ao esporte.

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Section: Methodsmentioning

confidence: 99%

Section: Descrição Dos Procedimentosunclassified

Section: Description Of the Proceduresmentioning

confidence: 99%

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Retorno ao esporte após osteotomia tibial alta com método de cunha de abertura

Nicolini

Christiano

Abdalla

et al. 2020

Rev Bras Ortop (Sao Paulo)

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“…There is no consensus in the literature on the optimal fixation device 12) or a surgical technique for an open wedge osteotomy 13) . Although plates 12) are commonly used for fixation of open wedge osteotomy, their biomechanical stability is still under investigation and longer and thicker plates are recommended 14) .…”

Section: Introductionmentioning

confidence: 99%

“…But relatively bigger plates need a larger incision and can cause irritation of thin overlying medial soft-tissue cover 15) . There is a need, therefore, for a surgical technique characterized by less invasive surgical methods, biological osteotomy techniques, more rigid fixation, accelerated rehabilitation, and lower surgical risk of complications 13 , 15) . The purpose of this prospective study was to document results of PTO below the tibial tuberosity using an intramedullary nail in a consecutive series of young adults treated in our institute for varus deformity of the knee.…”

Section: Introductionmentioning

confidence: 99%

Corrective Tibial Osteotomy in Young Adults Using an Intramedullary Nail

Kim

Thaller²,

Ramteke

et al. 2014

Knee Surg Relat Res

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PurposeThe purpose of this study was to document results of a less invasive technique of open wedge proximal tibial osteotomy (PTO) for the varus knee in young adults using an intramedullary tibial nail.Materials and MethodsWe prospectively studied 24 knees in 16 young patients with varus knee deformity. The mean follow-up was 54 months (range, 36 to 107 months) and the mean age of patients at the time of operation was 25.8 years (range, 18 to 40 years). The open wedge PTO was performed below tibial tuberosity using a percutaneous multiple drill-hole technique. Conventional intramedullary tibial nail was used for fixation without bone graft. Radiographic evaluations were made using mechanical alignment (MA), posterior tibial slope angle, and Insall-Salvati ratio. Union time, loss of correction, implant failure, and associated complications were also investigated.ResultsThe mean MA was significantly changed from -9.7° preoperatively to 1.1° at the final follow-up (p<0.001). There was no significant change in the proximal tibial anatomy and patellar height. All patients achieved radiographic bony union at an average of 3.1 months without loss of correction. The only complication was knee pain due to nail prominence in 3 patients.ConclusionsRadiographic evaluation indicated that PTO using an intramedullary tibial nail leads to significant improvement in radiographic parameters without changes in posterior tibial slope or patellar height. We found that this technique could be a less invasive and effective alternative for correction of the varus knee in young adults.

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