Posteromedial Opening-Wedge Tibial Osteotomy for Metaphyseal Varus and Abnormal Posterior Slope Correction in Failed Anterior Cruciate Ligament Reconstructions Using a Custom Cutting Guide

Corin, Boris; Wilson, Adrian; Khakha, Raghbir; Kley, Kristian; Parratte, Sébastien; Ollivier, Matthieu

doi:10.1016/j.eats.2020.04.008

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…An additional study was excluded because it investigated the osteotomy procedure to correct tibial plateau fractures’ non-union [ 12 ]. A total of 28 articles [ 6 , 7 , 8 , 9 , 10 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] were included in this systematic review ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Custom-Made Devices Represent a Promising Tool to Increase Correction Accuracy of High Tibial Osteotomy: A Systematic Review of the Literature and Presentation of Pilot Cases with a New 3D-Printed System

Zaffagnini

Fabbro

Belvedere

et al. 2022

JCM

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Background: The accuracy of the coronal alignment corrections using conventional high tibial osteotomy (HTO) falls short, and multiplanar deformities of the tibia require consideration of both the coronal and sagittal planes. Patient-specific instrumentations have been introduced to improve the control of the correction. Clear evidence about customized devices for HTO and their correction accuracy lacks. Methods: The databases PUBMED and EMBASE were systematically screened for human and cadaveric studies about the use of customized devices for high tibial osteotomy and their outcomes concerning correction accuracy. Furthermore, a 3D-printed customized system for valgus HTO with three pilot cases at one-year follow-up was presented. Results: 28 studies were included. The most commonly used custom-made devices for HTO were found to be cutting guides. Reported differences between the achieved and targeted correction of hip-knee-ankle angle and the posterior tibial slope were 3° or under. The three pilot cases that underwent personalized HTO with a new 3D-printed device presented satisfactory alignment and clinical outcomes at one-year follow-up. Conclusion: The available patient-specific devices described in the literature, including the one used in the preliminary cases of the current study, showed promising results in increasing the accuracy of correction in HTO procedure.

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Section: Resultsmentioning

confidence: 99%

Custom-Made Devices Represent a Promising Tool to Increase Correction Accuracy of High Tibial Osteotomy: A Systematic Review of the Literature and Presentation of Pilot Cases with a New 3D-Printed System

Zaffagnini

Fabbro

Belvedere

et al. 2022

JCM

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“… 11 Three-dimensional preoperative planning could help the surgeon to conceive biplanar osteotomy with asymmetric anterior closure. A posteromedial opening wedge-HTO could also be performed when metaphyseal tibial varus deformity is diagnosed, 22 but a MOW-HTO will be more restrictive in correcting the slope just as an ACW-HTO in correcting the varus.…”

Section: Discussionmentioning

confidence: 99%

“…The patella, the patellar tendon, and the tibial tubercle are identified: the incision is longitudinal and centered on these landmarks. diagnosed, 22 but a MOW-HTO will be more restrictive in correcting the slope just as an ACW-HTO in correcting the varus.…”

Section: Rehabilitationmentioning

confidence: 99%

Anterior Closing-Wedge High Tibial Osteotomy Using Patient-Specific Cutting Guide in Chronic Anterior Cruciate Ligament–Deficient Knees

Guy

Khakha

Ollivier

2022

Arthroscopy Techniques

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“…Patient-specific cutting guides could ease the learning curve, reduce operating time, and decrease the use of fluoroscopy. 11,24 It remains to be seen whether they can help to minimize changes in patellar height indices.…”

Section: Guy Et Almentioning

confidence: 99%

The Influence of Tibial Tubercle–Sparing Slope-Reducing Osteotomy on Patellar Height in Patients Undergoing Revision ACL Reconstruction

Guy,

Saithna,

Ferreira

et al. 2024

Am J Sports Med

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Background: A posterior tibial slope (PTS) >12° is an independent risk factor for anterior cruciate ligament (ACL) graft rupture, and a high tibial osteotomy (HTO) for slope correction can help avoid it. Management of patellar height is of major concern when performing HTO. Purpose: To evaluate the effect of tibial tubercle–sparing anterior closing-wedge osteotomy on patellar height in revision ACL reconstruction (ACLR). Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent arthroscopic revision ACLR combined with retro–tibial tubercle anterior closing-wedge HTO (ACW-HTO) between January 1, 2016, and March 31, 2021, were assessed for eligibility. Patellar height was measured on full weightbearing lateral radiographs according to the Insall-Salvati index (ISI) and Caton-Deschamps index (CDI) or frontal radiographs using the femoral patellar height index. The PTS was evaluated using the proximal anatomic axis of the tibia on standard short lateral radiographs. The delta (postoperative – preoperative) and the ratio (preoperative/postoperative) of the 3 patellar height indices and PTS were calculated. Preoperative and postoperative patellar heights were compared using independent t tests for each index. Also investigated was whether patients changed patellar height category (baja, normal, or alta) after slope osteotomy. Results: Among 475 revision ACLRs, 47 tibial tubercle–sparing ACW-HTOs were retained for analysis. No significant difference in patellar height was found between pre- and postoperative radiographs regardless of the index (preoperative – postoperative) (ISI: 1.0 ± 0.2 – 0.9 ± 0.2, P = .1729; CDI: 1.0 ± 0.2 – 1.0 ± 0.2, P = .4034; femoral patellar height index: 1.5 ± 0.2 – 1.5 ± 0.2; P = .5130). Fifteen patients (31.9%) exhibited a postoperative change in their patellar height category when measured by the ISI (6 moved up a category, 9 moved down one), and 18 patients (38.3%) changed category according to the CDI (10 moved up a category, 8 moved down one). No significant difference was found between pre- and postoperative patellar height among these patients (ISI: P = .2418; CDI: P = .3005). Conclusion: Changes in patellar height ratio are common after tibial tubercle–sparing ACW-HTO in patients undergoing revision ACLR. The clinical effect of these changes is unknown, and further study is needed to investigate whether they may result in patellofemoral symptoms.

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Posteromedial Opening-Wedge Tibial Osteotomy for Metaphyseal Varus and Abnormal Posterior Slope Correction in Failed Anterior Cruciate Ligament Reconstructions Using a Custom Cutting Guide

Cited by 9 publications

References 11 publications

Custom-Made Devices Represent a Promising Tool to Increase Correction Accuracy of High Tibial Osteotomy: A Systematic Review of the Literature and Presentation of Pilot Cases with a New 3D-Printed System

Custom-Made Devices Represent a Promising Tool to Increase Correction Accuracy of High Tibial Osteotomy: A Systematic Review of the Literature and Presentation of Pilot Cases with a New 3D-Printed System

Anterior Closing-Wedge High Tibial Osteotomy Using Patient-Specific Cutting Guide in Chronic Anterior Cruciate Ligament–Deficient Knees

The Influence of Tibial Tubercle–Sparing Slope-Reducing Osteotomy on Patellar Height in Patients Undergoing Revision ACL Reconstruction

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