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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 (Department of Mechanical Engineering, Hanyang University) ;
  • Park, Byoung-Keon (Department of Mechanical Engineering, Hanyang University) ;
  • Choi, Dong-Kwon (Department of Mechanical Engineering, Hanyang University) ;
  • Kim, Jay-Jung (Department of Mechanical Engineering, Hanyang University)
  • Received : 2013.09.11
  • Accepted : 2013.10.30
  • Published : 2013.12.01

Abstract

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.

Keywords

References

  1. Billings, A., Scott, D.F. and Camargo, M.P., 2000, High Tibial Osteotomy with a Calibrated Osteotomy Guide, Rigid Internal Fixation, and Early Motion Long-term Follow-up, The Journal of Bone & Joint Surgery [Am], 82, pp.70-79.
  2. Hernigou, P. and Ma, W., 2001, Open Wedge Tibial Osteotomy with Acrylic Bone Cement as Bone Substitute, Knee, 8, pp.103-110. https://doi.org/10.1016/S0968-0160(00)00061-2
  3. Noyes, F.R., Barber-Westin, S.D. and Hewett, T.E., 2000, High Tibial Osteotomy and Ligament Reconstruction for Varus Angulmed Anterior Cruciate Ligament-deficient Knees, Journal of Sports Medicine [Am], 28, pp.282-296. https://doi.org/10.1177/03635465000280030201
  4. Marti, C.B., Gautier, E., Wachtl, S.W. and Jakob, R.P., 2004, Accuracy of Frontal and Sagittal Plane Correction in Open-wedge High Tibial Osteotomy, Arthroscopy, 20, pp.366-372. https://doi.org/10.1016/j.arthro.2004.01.024
  5. Poilvache, P., 2006, "Osteotomy for the Arthritic Knee: a European Perspective", In: Scott WN ed. Surgery of the Knee. 4th ed. Philadelphia, Elsevier Inc, pp.1321-1366.
  6. Koo, B.Y., Kim, C.W., Lee, S.H., Bae, J.H., Park, C.W. and Kim, J.J., 2011, Development of Computer-Aided Surgery System for High Tibial Osteotomy Using Tracking-Pin and Fluoroscopic G-arm Images, Transactions of the Society of CAD/CAM Engineers, 16(5), pp.331-343.
  7. Amend ola, A. and Panarella, L., 2005, High Tibial Osteotomy for the Treatment of Unicompartmental Arthritis of the Knee, Orthopedic Clinics of North America, 36, pp.497-504. https://doi.org/10.1016/j.ocl.2005.05.009
  8. Ellis, R.E., Tso, C.Y., Rudan, J.F. and Harrison, M.M., 1999, A Surgical Planning and Guidance System for High Tibial Osteotomy, Computer Aided Surgery, 4, pp.264-274. https://doi.org/10.3109/10929089909148179
  9. Song, E.K., 2004, High Tibial Osteotomy for Osteoarthritis of the Knee, The Journal of the Korean Orthopaedic Association, 39, pp.104-107. https://doi.org/10.4055/jkoa.2004.39.1.104
  10. Song, E.K., Seon, J.K., Park, S.J. and Cho, N.Y., 2009, Open Wedge High Tibial Osteotomy with Aescular Plate, The Journal of the Korean Orthopaedic Association, 43, pp.391-395.
  11. 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, 15, pp.128-133.
  12. 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, 6, pp.904-910.
  13. Ozalay, M., Ozkoc, G., Circi, E., Akp nar, 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 Surgery,Sports Traumatology, Arthroscopy, 16, pp.948-951. https://doi.org/10.1007/s00167-008-0589-8
  14. Giffin, J.R., Vogrin, T.M., Zantop, T., Woo, S. L. and Harner, C.D., 2004, Effects of Increasing Tibial Slope on the Biomechanics of the Knee, The American Journal of Sports Medicine, 32, pp.376-382. https://doi.org/10.1177/0363546503258880
  15. Cullu, E., Aydogdu, S., Alparslan, B. and Sur, H., 2005, Tibial Slope Changes Following Dometype High Tibial Osteotomy, Knee Surgery,Sports Traumatology, Arthroscopy, 13, pp.38-43. https://doi.org/10.1007/s00167-004-0501-0
  16. 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, 37, pp.2411-2418. https://doi.org/10.1177/0363546509341174
  17. Ho hmann, E. and Bryant, A., 2007, Closing or Opening Wedge High Tibial Osteotomy: Watch Out for the Slope, Operative Technique in Orthopaedics, 17, pp.38-45. https://doi.org/10.1053/j.oto.2006.09.010
  18. Noyes, F.R., Mayfield, W., Barber-Westin, S.D., Albright, J.C. and Heckmann, T.P., 2006, Opening Wedge High Tibial Osteotomy: An Operative Technique and Rehabilitation Program to Decrease Complications and Promote Early Union and Function, The American Journal of Sports Medicine, 34, pp.1262-1273. https://doi.org/10.1177/0363546505286144
  19. Hernigou, P., Ovadia, H. and Goutallier, D., 1992, Mathematical Modeling of Openwedge Tibial Osteotomy and Correction Tables (french), Rev Chir Orthop Reparatrice Appar Mot, 78, pp.258-263.
  20. Koshino, T., Murase, T. and Saito, T., 2003, Medial Opening-wedge High Tibial Osteotomy with Use of Porous Hydroxyapatite to Treat Medial Compartment Osteoarthritis of the Knee, The Journal of Bone & Joint Surgery, 85, pp.78-85. https://doi.org/10.1302/0301-620X.85B1.12468
  21. 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, 33, pp.378-387. https://doi.org/10.1177/0363546504269034
  22. Lee, Y.S., Park, S.J., Shin, V.I., Lee, J.H., Kim, Y.H. and Song, E.K., 2010, Achievement of Targeted Posterior Slope in the Medial Opening Wedge High Tibial Osteotomy: A Mathematical Approach, Annals of Biomedical Engineering, 38, pp.583-593. https://doi.org/10.1007/s10439-009-9860-5
  23. Glenn, M., 2010, Rotation About an Arbitrary Axis in 3 Dimensions, Available: http://inside.mines.edu/-gmurray/ArbitraryAxisRotation/ArbitraryAxisRotation.html
  24. Zorzi, A.R., Sliva, H.G.P.V., Muszkat, C., Marques, L.C., Jr, A.C. and Miranda, J.B., 2011, Openingwedge High Tibial Osteotomy with and without Bone Graft, Artificial Organs, 35, pp.301-307. https://doi.org/10.1111/j.1525-1594.2010.01058.x
  25. Kolb, W., Guhlmann H., Windisch, C., Kolb, K., Koller, H. and Grutzner, P., 2009, Openingwedge High Tibial Osteotomy with a Locked Low-profile Plate, The Journal of Bone & Joint Surgery Am, 91, pp.2581-2588. https://doi.org/10.2106/JBJS.H.01047