Transactions of the Korean Society of Mechanical Engineers A (대한기계학회논문집A)

The Korean Society of Mechanical Engineers (대한기계학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Tibial Cut Planes and Hinge Axes on Medial Opening Wedge High Tibial Osteotomy

내측개방형 근위경골절골술의 경골절단면 및 경골개방축의 설정에 따른 영향

  • Received : 2010.04.23
  • Accepted : 2011.05.21
  • Published : 2011.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

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.

최근 보편화 되고 있는 내측개방형절골술 시에 의도하지 않은 경골후방경사각의 변화로 인한 문제점들이 보고되었다. 이를 해결하기 위해 많은 연구들이 진행되어 왔지만 환자의 다양한 경골의 형상 및 절단면의 기울기에 적용될 수 있는 일반적 해석 모델은 아직 제안되지 못하고 있다. 따라서 본 논문에서는 일반적인 케이스에 적용할 수 있는 근위경골절골술의 해석 모델을 제안한다. 이를 위해 내반교정각만을 조정할 수 있는 가상경골축을 정의하고, 이를 통해 절단면과 경골개방축이 내반교정각에 주는 영향을 나타내는 수학적 모델을 제안하고, 기존의 수술적인 변수들간의 상관관계를 명확히 나타내었다. 또한 내반교정각과 경골후방경사각에 추가로, 새로운 각도인 경골뒤틀림각의 존재를 도입함으로써 수술 시 발생하는 모든 기하학적 변수들간의 관계를 완성된 형태로 표현하였다.

Keywords

References

  1. Insall, J.N., Joseph, D.M. and Msika, C., 1984, "High Tibial Osteotomy for Varus Gonarthrosis. A Long-Term Follow-up Study," J Bone Joint Surg Am, Vol. 66, pp.1040-1048. https://doi.org/10.2106/00004623-198466070-00010
  2. Song, E.-K., 2004, "High Tibial Osteotomy for Osterarthritis of the Knee," J. of Korean Orthop. Assoc., Vol. 39, No.1, pp.104-107.
  3. Song, E.-K., Seon, J.-K., Park, S.-J. and Cho, N.-Y., 2009, "Open Wedge High Tibial Osteotomy with$ Aescula^{\circledR}$ Plate," J. of Korean Orthop. Assoc., Vol. 43, No. 3, pp. 391-395.
  4. Chae, D. J., Shetty, G. M., Lee, D. B., Choi, H. W., Han, S. B. and Nha, K. W., 2007, "Tibial Slope and Patellar Height After Opening Wedge High Tibia Osteotomy Using Autologous Tricortical Iliac Bone Graft," The Knee, Vol. 15, pp. 128-133.
  5. Kendoff, D., Lo, D., Goleski, P., Warkentine, B., Loughlin, P. F. O. and Pearle, A. D., 2008, "Open Wedge Tibial Osteotomies Influence on Axial Rotation and Tibial Slope," Knee Surg Sports Traumatol Arthrosc, Vol. 6, pp. 904-910.
  6. Ozalay, M., Ozkoc, G. and Circi, E., Akpınar, S., Hersekli, M. A., Uysal, M. and Cesur, N., 2008, "The Correlation of Correction Magnitude and Tibial Slope Changes Following Open Wedge High Tibial Osteotomy," Knee Surg Sports Trumatol Arthrosc, Vol. 16, pp. 948-951. https://doi.org/10.1007/s00167-008-0589-8
  7. Wang, J., H., Bae, J. H., Lim, H. C., Shon, W. Y., Kim, C. W. and Cho, J. W., 2009, "Medial Open Wedge High Tibial Osteotomy : The Effect of the Cortical Hinge on Posterior Tibial Slope," The American Journal of Sports Medicine, Vol. 37, No. 12, pp. 2411-2418. https://doi.org/10.1177/0363546509341174
  8. Hohmann, E. and Bryant, A., 2007, "Closing or Opening Wedge High Tibial osteotomy : Watch Out for the Slope," Operative Technique in Orthopaedics, Vol. 17, pp. 38-45. https://doi.org/10.1053/j.oto.2006.09.010
  9. Noyes, F. R., Goebel, S. X. and West, J., 2005, "Opening Wedge Tibial Osteotomy : The 3-Triangle Method to Correct Axial Alignment and Tibial Slope," The American Journal of Sports Medicine, Vol. 33, No. 3, pp. 378-387. https://doi.org/10.1177/0363546504269034
  10. Lee, Y. S., Park, S. J., Shin, V. I., Lee, J. H., Kim, Y. H. and Song, E. K., 2009, "Achievement of Targeted Posterior Slope in the Medial Opening Wedge High Tibail Osteotomy: A Methmatical Approach," Annals of Biomedical Engineering,
  11. Suh, N. P., 1998, "Axiomatic Design Theory for Systems," Research in Engineering Design, Vol. 10, No.4, pp. 189-209. https://doi.org/10.1007/s001639870001
  12. Glenn, M., 2005, "Rotation About an Arbitrary Axis in 3 Dimensions," http://inside.mines.edu/-gmurray/ArbitraryAxisRotation/ArbitraryAxisRotation.html
  13. Craig, J. J., "Introduction to Robotics: Mechanics and Control," 3rd Edition, Addison-Wesley Publishing Company, pp. 19-24.
  14. Matsuda, Y., Ishii, Y. and Ichimura, K., 2004 "Identifying the Center of the Femoral Head Using Ultrasonography to Assess the Higher Accuracy of Femoral Extramedullary Guides in TKA," Journal of Orthopaedic Science, Vol. 9(1), pp. 6-9. https://doi.org/10.1007/s00776-003-0738-3