The 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model
Abstract Purpose Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over‐ and under‐corrections as well as unintended changes of the posterior tibial slope. Noyes et al....
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-022-00466-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849735073950072832 |
|---|---|
| author | Manuel Weißenberger Mike Wagenbrenner Fritz Schote Konstantin Horas Thomas Schäfer Maximilian Rudert Thomas Barthel Tizian Heinz Stephan Reppenhagen |
| author_facet | Manuel Weißenberger Mike Wagenbrenner Fritz Schote Konstantin Horas Thomas Schäfer Maximilian Rudert Thomas Barthel Tizian Heinz Stephan Reppenhagen |
| author_sort | Manuel Weißenberger |
| collection | DOAJ |
| description | Abstract Purpose Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over‐ and under‐corrections as well as unintended changes of the posterior tibial slope. Noyes et al. reported a novel method for accurate intraoperative coronal and sagittal alignment correction based on a three‐dimensional mathematical model. This is the first study examining preliminary data via the proposed Noyes approach for accurate intraoperative coronal and sagittal alignment correction during HTO. Methods From 2016 to 2020 a total of 24 patients (27 knees) underwent HTO applying the proposed Noyes method (Noyes‐Group). Radiographic data was analyzed retrospectively and matched to patients that underwent HTO using the conventional method, i.e., gradual medial opening using a bone spreader under fluoroscopic control (Conventional‐Group). All operative procedures were performed by an experienced surgeon at a single orthopaedic university center. Results From the preoperative to the postoperative visit no statistically significant changes of the posterior tibial slope were noted in the Noyes‐Group compared to a significant increase in the Conventional‐Group (p = 0.01). Regarding the axial alignment no significant differences between both groups were observed pre‐ and postoperatively. The number of over‐ and under‐corrections did not differ significantly between both groups. Linear regression analysis showed a significant correlation of the postoperative medial proximal tibial angle (MPTA) with the position of the weightbearing line on the tibial plateau. Conclusion The 3‐triangle method by Noyes seems to be a promising approach for preservation of the posterior tibial slope during HTO. |
| format | Article |
| id | doaj-art-48239be1cea84a2caab1ae6af8558876 |
| institution | DOAJ |
| issn | 2197-1153 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-48239be1cea84a2caab1ae6af85588762025-08-20T03:07:38ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00466-yThe 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical modelManuel Weißenberger0Mike Wagenbrenner1Fritz Schote2Konstantin Horas3Thomas Schäfer4Maximilian Rudert5Thomas Barthel6Tizian Heinz7Stephan Reppenhagen8Department of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐Haus, Brettreichstr. 1197074WuerzburgGermanyAbstract Purpose Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over‐ and under‐corrections as well as unintended changes of the posterior tibial slope. Noyes et al. reported a novel method for accurate intraoperative coronal and sagittal alignment correction based on a three‐dimensional mathematical model. This is the first study examining preliminary data via the proposed Noyes approach for accurate intraoperative coronal and sagittal alignment correction during HTO. Methods From 2016 to 2020 a total of 24 patients (27 knees) underwent HTO applying the proposed Noyes method (Noyes‐Group). Radiographic data was analyzed retrospectively and matched to patients that underwent HTO using the conventional method, i.e., gradual medial opening using a bone spreader under fluoroscopic control (Conventional‐Group). All operative procedures were performed by an experienced surgeon at a single orthopaedic university center. Results From the preoperative to the postoperative visit no statistically significant changes of the posterior tibial slope were noted in the Noyes‐Group compared to a significant increase in the Conventional‐Group (p = 0.01). Regarding the axial alignment no significant differences between both groups were observed pre‐ and postoperatively. The number of over‐ and under‐corrections did not differ significantly between both groups. Linear regression analysis showed a significant correlation of the postoperative medial proximal tibial angle (MPTA) with the position of the weightbearing line on the tibial plateau. Conclusion The 3‐triangle method by Noyes seems to be a promising approach for preservation of the posterior tibial slope during HTO.https://doi.org/10.1186/s40634-022-00466-yKneeHigh tibial valgus osteotomyAxial alignmentPosterior tibial slopeWeight bearing lineCartilage |
| spellingShingle | Manuel Weißenberger Mike Wagenbrenner Fritz Schote Konstantin Horas Thomas Schäfer Maximilian Rudert Thomas Barthel Tizian Heinz Stephan Reppenhagen The 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model Journal of Experimental Orthopaedics Knee High tibial valgus osteotomy Axial alignment Posterior tibial slope Weight bearing line Cartilage |
| title | The 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model |
| title_full | The 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model |
| title_fullStr | The 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model |
| title_full_unstemmed | The 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model |
| title_short | The 3‐triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model |
| title_sort | 3 triangle method preserves the posterior tibial slope during high tibial valgus osteotomy first preliminary data using a mathematical model |
| topic | Knee High tibial valgus osteotomy Axial alignment Posterior tibial slope Weight bearing line Cartilage |
| url | https://doi.org/10.1186/s40634-022-00466-y |
| work_keys_str_mv | AT manuelweißenberger the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT mikewagenbrenner the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT fritzschote the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT konstantinhoras the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT thomasschafer the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT maximilianrudert the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT thomasbarthel the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT tizianheinz the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT stephanreppenhagen the3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT manuelweißenberger 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT mikewagenbrenner 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT fritzschote 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT konstantinhoras 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT thomasschafer 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT maximilianrudert 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT thomasbarthel 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT tizianheinz 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel AT stephanreppenhagen 3trianglemethodpreservestheposteriortibialslopeduringhightibialvalgusosteotomyfirstpreliminarydatausingamathematicalmodel |