• Title/Summary/Keyword: High Tibial Osteotomy

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Analytical Osteotomy Model for Three-dimensional Surgical Planning of Opening Wedge High Tibial Osteotomy (개방형 근위경골절골술의 3차원 수술계획을 위한 절골해석모델)

  • Koo, Bon-Yeol;Park, Byoung-Keon;Choi, Dong-Kwon;Kim, Jay-Jung
    • Korean Journal of Computational Design and Engineering
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    • v.18 no.6
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    • pp.385-398
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    • 2013
  • Opening wedge high tibial osteotomy (OWHTO) is widely used to treat unicompartmental osteoarthritis of the knee caused by degenerative deformations of the anatomical axes of the leg. However, since it is difficult to accurately plan the surgical degrees of adjustment such as coronal correction angle and tibial posterior slope angle to align the axes before the actual procedure, a number of studies have proposed analytical models to solve this problem. While previous analytical models for OWHTO were limited to specific cases, this study proposes an analytical osteotomy model (AOM) and a surgical planning system (SPS) that are suitable for a wide range of tibial morphologies and tibia conditions. The validity and generality of the model were verified in a total of 60 OWHTO cases. Results of the test showed that, as predicted, surgical degrees are affected quite significantly by tibia shape and slope of the resected surface. Comparison of the required surgical degrees and the degrees estimated from virtual surgery simulations using AOM showed a very small average difference of $0.118^{\circ}$. SPS, based on AOM, allows the operating surgeon to easily calculate surgical parameters needed to treat a patient.

The Effect of Anatomical Axis and Mechanical Axis on Change of Posterior Tibial Slope Angle in PTO(Proximal Tibial Osteotomy) (근위경골절골술에서 해부학적 축과 역학적 축의 변화가 경골후방경사각에 미치는 영향)

  • Shin, Eun-Ji;Kim, Cheol-Woong;Lee, Ho-Sang;Bae, Ji-Hoon;Wang, Joon-Ho;Park, Jong-Woong;Oh, Dong-Joon
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1543-1546
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    • 2008
  • The purpose of this study was to investigate factors affecting the change of tibial posterior slope and introduce a mathematical model which calculate, through 3-dimensional analysis of the proximal tibia, how the angle of the opening wedge along the anteromedial tibial cortex influences the tibial posterior slope and valgus correction when performing a medial open wedge osteotomy. This mathematical model with navigation system can be guidelines which provide surgeons on preoperative and intraoperative measurements to maintain or correct the tibial slope and to obtain the desired valgus correction of the lower limb during an opening wedge osteotomy.

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Correlation between femoral rotation and clinical results after high tibial osteotomy in primary osteoarthritis patient (퇴행성 골관절염 환자에서 시행한 근위 경골 절골술 후 대퇴골의 회전과 임상결과의 상관관계)

  • Park, Sang Eun;Mun, Sang Won
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.100-104
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    • 2011
  • The purpose of this article is to examine correlation between femoral rotational angle and subjective satisfaction of high tibial osteotomy outcome of the range of motion of knee joint. The subjects were 15 patients (6 males, 9 females) with primary osteoarthritis undergoing high tibial osteotomy from June of 2004 to August of 2008. They were CT tested on the knee joint before and after high tibial osteotomy. TEA (Fig. 1) and Akagi's line (Fig. 2) are analyzed as percentages. The Kendall's and Spearman's nonparametric correlation coefficient were used for the statistical tests with 0.5 level of significance. The result reveals that femoral rotational angle correlates with not the range of motion of knee joint but subjective satisfaction of the patients. Therefore, this will enable patients and physicians to have better clinical outcome.

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Development of Computer-Aided Surgery System for High Tibial Osteotomy Using Tracking-Pin and Fluoroscopic G-arm Images (Tracking-Pin과 Fluoroscopic G-arm 이미지를 이용한 경골근위부절골술 지원시스템 개발)

  • Koo, Bon-Yeol;Kim, Cheol-Woong;Lee, Sun-Hyuk;Bae, Ji-Hoon;Park, Cheol-Woo;Kim, Jay-Jung
    • Korean Journal of Computational Design and Engineering
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    • v.16 no.5
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    • pp.331-343
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    • 2011
  • High tibial osteotomy (HTO) is a widely accepted treatment for unicompartmental osteoarthritis of the knee and other lower extremity deformities, particularly for young and active patients. However, it is generally recognized as a technically demanding procedure. Thus the limitations of conventional surgical methods have been reported. Currently, the use of computer-aided surgery (CAS) system for successful surgery was increased. However it has been reported many problems such as expensive equipment, infection or fracture caused by inserting half-pin and delaying surgery. Therefore we propose a novel method which can be tracked by using tracking-pin inserted in arbitrary locations of the femur and tibia, and fluoroscopic images obtained from G-arm of antero-posterior and lateral-medial.

Effect of Tibial Cut Planes and Hinge Axes on Medial Opening Wedge High Tibial Osteotomy (내측개방형 근위경골절골술의 경골절단면 및 경골개방축의 설정에 따른 영향)

  • Park, Byoung-Keon;Lee, Ho-Sang;Kim, Jay-Jung;Kim, Cheol-Woong
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.35 no.8
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    • pp.835-846
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    • 2011
  • In medial opening wedge high tibial osteotomy (OWHTO), researchers have reported critical problems caused by unexpected changes in the tibial posterior-slope angle. This unexpected change can be analyzed, but there is no general solution for cases with an oblique hinge axis and cut plane. We propose a general analysis model for OWHTO. We first evaluate the effects according to variation in the hinge axis and tibial cut plane and then define an ideal correction axis. This ideal axis, called the virtual tibial correction axis, is not on the tibial cut plane in general. In this paper, we also present an evaluation of feasibility of the proposed analysis model.

The Effect of Anteromedial Tibial Cortex Angle on Change of Posterior Tibial Slope Angle in PTO(Proximal Tibial Osteotomy) using Computer Assisted Surgery(CAS) (Computer Assisted Surgery(CAS)를 이용한 개방형 쐐기 근위경골 절골술에서 전내측 경골피질경사각이 후방경골경사각의 변화에 미치는 영향)

  • Lee, Ho-Sang;Kim, Cheol-Woong;Bae, Ji-Hoon;Wang, Joon-Ho;Park, Jong-Woong;Oh, Dong-Joon
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1467-1470
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    • 2008
  • An upper tibial opening wedge osteotomy is an operation to cure a malalignment and a degenerate arthritis. To prevent the postoperative malalignment caused by the upper tibial opening wedge osteotomy, the research to define the relationship between a Hinge Axis Angle and a Posterior Slope Angle is needed. The effect of the relationship between the hinge axis angle and the gap angle on the posterior slope angle is studied. After 3-D Compute Tomography (CT) scanning image is reconstructed, the virtual surgery is performed by the reconstructed 3-D tibia model. It was proved that the relationship between the hinge axis angle and the gap angle were constant and the simple mathematical model could be derived. To verify the suggested mathematical model, it compared with the measured data from the virtual surgery. In conclusion, while the deviation between the data from the virtual surgery and ones of the mathematical model under the gap angle<$10^{\circ}$ was less than 1%.

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Pseudoaneurysm Formation due to Popliteal Artery Injury Caused by Drilling during Medial Opening Wedge High Tibial Osteotomy

  • Chun, Keun Churl;So, Byung Jun;Kang, Hyun Tak;Chun, Churl-Hong
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.364-368
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    • 2018
  • We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.