Osteotomy around the knee is planned toward an anatomical bone correction in less than half of patients

Micicoi, Grégoire; Grasso, Francesco; Kley, Kristian; Favreau, Henri; Khakha, Raghbir; Ehlinger, Matthieu; Jacquet, Christophe; Ollivier, Matthieu

doi:10.1016/j.otsr.2021.102897

Cited by 33 publications

(14 citation statements)

References 44 publications

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“…This study demonstrated that in patients requiring osteotomies around the knee, DLO is required in approximately 60% of cases, and even if DLO is performed, postoperative mMPTA exceeds 95° in approximately 40% of cases. A preoperatively lower HKA was associated with nonanatomical correction for tibial abnormalities after osteotomies around the knee in a previous study [21]. However, the HKA consists of deformities in the mLDFA, JLCA and mMPTA.…”

Section: Discussionmentioning

confidence: 70%

Potential anatomic risk factors resulting oversized postoperative medial proximal tibial angle after double level osteotomy

Nejima

Kumagai

Yamada

et al. 2022

BMC Musculoskelet Disord

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Background Double level osteotomy (DLO) has been introduced to prevent increased postoperative joint line obliquity. However, although DLO is planned, knees with postoperative medial proximal tibial angle (MPTA) > 95° in preoperative surgical planning are present. This retrospective study aimed to evaluate risk factors for an MPTA > 95° in preoperative surgical planning for DLO in patients with varus knee osteoarthritis (OA). Methods A total of 168 knees that underwent osteotomies around the knee for varus knee OA were enrolled. The hip-knee-ankle angle (HKA), weight-bearing line (WBL) ratio, mechanical lateral distal femoral angle (mLDFA), joint line convergence angle (JLCA) and mechanical medial proximal tibial angle (mMPTA) were measured on preoperative radiographs. The postoperative WBL ratio was planned to be 62.5%. When the postoperative mMPTA was more than 95° in isolated high tibial osteotomy (HTO), (DLO) was planned so that the postoperative mLDFA was 85°, and residual deformity was corrected by HTO. Knees with postoperative mMPTA ≤ 95° and > 95° were classified into the correctable group and uncorrectable group, respectively. Results DLO was required in 101 knees (60.1%). Among them, 41 knees (40.6%) were classified into the uncorrectable group. Binomial logistic regression analysis showed that preoperative JLCA and mMPTA were independent predictors in the uncorrectable group. Conclusions Even with DLO, postoperative mMPTA was more than 95° in approximately 40% of cases. Preoperative increased JLCA and decreased mMPTA were risk factors for a postoperative mMPTA of > 95° after DLO.

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Section: Discussionmentioning

confidence: 70%

Potential anatomic risk factors resulting oversized postoperative medial proximal tibial angle after double level osteotomy

Nejima

Kumagai

Yamada

et al. 2022

BMC Musculoskelet Disord

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“…In our experience, the frequent use of femoral osteotomy has opened our eyes to the unfavourable outcomes of patients with "everything in the tibia" corrected. A recent study based on planned osteotomies with custom-made cutting guides reported a correction site error in 50% of procedures performed with the creation of very abnormal bone morphology [14].…”

Section: Discussionmentioning

confidence: 99%

Lateral femoral closing wedge osteotomy in genu varum

Ollivier¹,

Fabre-Aubrespy²,

Micicoi³

et al. 2021

Orthopaedics & Traumatology: Surgery & Research

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“…Many authors advocated for more distal osteotomy below the tibial tuberosity to reduce risk of patella infera [13,28,29]. Double-level osteotomy does not seem to prevent patellar descent [30] but does reduce the rate of non-anatomic correction [31,32]. According to Otsuki et al [33], hybrid tibial osteotomy can be performed in case of pre-existing patellofemoral osteoarthritis, associating 33% medial opening to 67% lateral closure to reduce the tibial tuberosity-trochlear groove (TT-TG) distance without lowering the patella.…”

Section: Discussionmentioning

confidence: 99%

Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope

Carissimi

Sautet

Charre

et al. 2021

Orthopaedics & Traumatology: Surgery & Research

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Osteotomy around the knee is planned toward an anatomical bone correction in less than half of patients

Cited by 33 publications

References 44 publications

Potential anatomic risk factors resulting oversized postoperative medial proximal tibial angle after double level osteotomy

Potential anatomic risk factors resulting oversized postoperative medial proximal tibial angle after double level osteotomy

Lateral femoral closing wedge osteotomy in genu varum

Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope

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