Reliability of two techniques and training level of the observer in measuring the correction angle when planning a high tibial osteotomy

Blackburn, Julia; Ansari, Aneel; Porteous, A; Murray, James R. D.

doi:10.1016/j.knee.2017.11.007

Cited by 16 publications

(10 citation statements)

References 24 publications

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“…Blackburn et al. [ 38 ] reported that Dugdale’s method showed high inter- and intra-rater reliabilities, which were not different from those of Miniaci’s method.…”

Section: Perioperative Planningmentioning

confidence: 99%

How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?

Kang

Lee

Kim

et al. 2022

Knee Surg & Relat Res

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Medial opening wedge high tibial osteotomy (MOWHTO) is a widely used surgical treatment option for medial compartmental osteoarthritis with varus deformity. It is important that proper lower limb alignment is achieved. However, there has been no consensus about an optimal alignment in MOWHTO. Most studies suggest that achieving valgus alignment is necessary, and recent studies support slight valgus mechanical alignment of less than 3° of mechanical femorotibial angle. Overcorrection and undercorrection is not recommended for achieving good surgical outcomes. To prevent undercorrection and overcorrection in MOWHTO, the method of placing the weight-bearing line in the target range must be precise. There are several ways to place a weight-bearing line within the target range. While the most important factor for a successful MOWHTO is achieving an ideal mechanical axis correction, there are a few other factors to consider, including joint line obliquity, posterior tibial slope, ligament balancing, and patellar height. Several factors exist that lead to undercorrection and overcorrection. Preoperative amount of varus deformity, lateral hinge fracture, and fixation failure can result in undercorrection, while medial soft tissue laxity and the amount of correction angle and target point beyond hypomochlion can result in overcorrection. This study aimed to review the literature on optimal alignment in MOWHTO and report on the factors to be considered to prevent correction errors and how to achieve an optimal alignment.

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“…Blackburn et al. [ 38 ] reported that Dugdale’s method showed high inter- and intra-rater reliabilities, which were not different from those of Miniaci’s method.…”

Section: Perioperative Planningmentioning

confidence: 99%

How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?

Kang

Lee

Kim

et al. 2022

Knee Surg & Relat Res

View full text Add to dashboard Cite

show abstract

“…The planning software has shown high interrater reproducibility [ 26 , 27 , 28 ] applying the Miniaci method [ 29 ]. Also, the Dugdale method [ 30 ] is a simple planning technique that also reveals high reliability and reproducibility [ 27 , 28 , 31 ], but is not recommended due to incorrect geometry leading to underestimation [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Influence of Medial Osteotomy Height and Hinge Position in Open Wedge High Tibial Osteotomy: A Simulation Study

et al. 2022

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(1) Background: In treating medial unicompartmental gonarthrosis, medial open wedge high tibial osteotomy (mOWHTO) reduces pain and is intended to delay a possible indication for joint replacement by relieving the affected compartment. This study aimed to investigate the influence of the osteotomy height with different hinge points in HTO in genu varum on the leg axis. (2) Methods: Fifty-five patients with varus lower leg alignment obtained full-weight bearing long-leg radiographs were analyzed. Different simulations were performed: Osteotomy height was selected at 3 and 4 cm distal to the tibial articular surface, and the hinge points were selected at 0.5 cm, 1 cm, and 1.5 cm medial to the fibular head, respectively. The target of each correction was 55% of the tibial plateau measured from the medial. Then, the width of the opening wedge was measured. Intraobserver and interobserver reliability were calculated. (3) Results: Statistically significant differences in wedge width were seen at an osteotomy height of 3 cm below the tibial plateau when the distance of the hinge from the fibular head was 0.5 cm to 1.5 cm (3 cm and 0.5 cm: 8.9 +/− 3.88 vs. 3 cm and 1.5 cm: 11.6 +/− 4.39 p = 0.012). Statistically significant differences were also found concerning the wedge width between the distances 0.5 to 1.5 cm from the fibular head at the osteotomy height of 4 cm below the tibial plateau. (4 cm and 0.5 cm: 9.0 +/− 3.76 vs. 4 cm and 1.5 cm: 11.4 +/− 4.27 p = 0.026). (4) Conclusion: A change of the lateral hinge position of 1 cm results in a change in wedge width of approximately 2 mm. If hinge positions are chosen differently in preoperative planning and intraoperatively, the result can lead to over- or under-correction.

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“…Planning techniques need to be reliable [21]. This study was done because existing software can only perform one of the procedures at a time.…”

Section: Discussionmentioning

confidence: 99%

Digital Preoperative Planning for High Tibial Osteotomy using 2D Medical Imaging

Awang¹,

Ahmad²,

Rahaman³

et al. 2021

IJACSA

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Reliability of two techniques and training level of the observer in measuring the correction angle when planning a high tibial osteotomy

Cited by 16 publications

References 24 publications

How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?

How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?

Influence of Medial Osteotomy Height and Hinge Position in Open Wedge High Tibial Osteotomy: A Simulation Study

Digital Preoperative Planning for High Tibial Osteotomy using 2D Medical Imaging

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