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Beitragstitel The influence of sagittal cutting planes on the posterior tibial slope in open wedge high tibial osteotomy: high tibial osteotomy on Sawbone model.
Beitragscode P37
  1. Elvin Gurbanov HUG Genève Vortragender
  2. Hermes H. Miozzari Hôpitaux Universitaires de Genève
  3. David Bauer
  4. Philippe Tscholl Geneva University Hospitals
Präsentationsform Poster
  • A05 - Knie
Abstract Introduction :

Medial-open-wedge-high-tibial-osteotomy (MOWHTO) is a widely used surgical technique for the treatment of medial compartment osteoarthritis. An unintended increase of the posterior tibial slope (PTS) is a frequently reported consequence. The aim of this study was to investigate the influence of different sagittal cutting orientations on the PTS.

Materials and methods :

Sixty Sawbone-Tibia models were used to produce biplanar MOWHTO. Three different orientations of the main osteotomy in the sagittal plane were produced: parallel to the medial tibial plateau (p-OT), 11° posteriorly ascending (90° to the anterior tibial cortex; a-OT) and 11° posteriorly descending (d-OT). In each group, 20 biplane osteotomies were performed, 10 with distal and 10 with proximal tibial tubercle osteotomy (TT). Medial opening was achieved with 3 D printed wedge-guide and 10 mm metal wedge. The PTS was measured prior and after the MOWHTO using the fast protocol, Brainlab knee 3 navigation system. Pre- and postoperative values were subtracted to calculate the difference in slope, where negative numbers describe an increase in PTS.

Results :

There was a significant difference in change of PTS after the osteotomies were performed between
p-OT -1.5 ± 0.7° and a-OT groups -0.9 ± 0.7° (p=0.044). We found statistically significant differences across subgroups in change in PTS between the p-OT ATT distal -1.7 ± 0.6° and the a-OT ATT distal -0.5 ± 0.6° (p=0.013) and between a-OT ATT distal -0.5 ± 0.6° and the d-OT ATT proximal -1.8 ± 0.8° (p=0.005).

Conclusion :

In current study different sagittal osteotomy orientations in MOWHTO had no or minor significant modification of PTS on Sawbone models with probable very low clinical relevance.