HSS Journal

, Volume 3, Issue 2, pp 155–158 | Cite as

The Coronal Plane High Tibial Osteotomy. Part II: A Comparison of Axial Rotation with the Opening Wedge High Tibial Osteotomy

  • Keith M. Baumgarten
  • Kate N. Meyers
  • Stephen Fealy
  • Timothy M. Wright
  • Thomas L. Wickiewicz
Original Article

Abstract

The amount of axial rotation in the tibia caused by high tibial osteotomy is relatively unknown. The authors hypothesize that the coronal plane high tibial osteotomy, a novel technique used to treat varus malalignment, alters the axial rotation of the tibia less than the opening wedge high tibial osteotomy. Eight, embalmed, stripped cadaveric tibia–fibula constructs with intact interosseous membranes were randomized to either opening wedge or coronal plane high tibial osteotomies. Sequential valgus corrections of 5°, 10°, and 15° were performed. The Qualisys Track Manager motion capture system was used to measure axial rotation. Student’s t test was used to compare axial rotation between the two groups. A p value of 0.05 was determined to be significant. The coronal plane technique produced rotations about the tibial axis that were statistically significantly smaller than those of the opening wedge technique for all correction angles (1.2° internal rotation (IR) vs 16° external rotation (ER), respectively, at 5° correction; p = 0.02) (3.5° IR vs 21.2° ER at 10° correction; p = 0.04) (4.5° IR vs 23.0° ER at 15° correction; p = 0.01). The coronal plane high tibial osteotomy alters axial rotation of the tibia significantly less than the opening wedge high tibial osteotomy.

Key words

knee osteotomy malalignment rotation coronal 

References

  1. 1.
    Coventry MB (1965) Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Jt Surg Am 47:984–990Google Scholar
  2. 2.
    Hernigou P, Medevielle D, Debeyre J, et al. (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Jt Surg Am 69(3):332–354Google Scholar
  3. 3.
    Koshino T, Murase T, Saito T (2003) Medial opening-wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee. J Bone Jt Surg Am 85-A(1):78–85Google Scholar
  4. 4.
    Kwok T (1992) Open wedge high tibial osteotomy using allo and autogenous bone grafts. J West Pac Orthop Assoc 29:93–97Google Scholar
  5. 5.
    Magyar G, Toksvig-Larsen S, Lindstrand A (1999) Changes in osseous correction after proximal tibial osteotomy: radiostereometry of closed- and open-wedge osteotomy in 33 patients. Acta Orthop Scand 70(5):473–477PubMedCrossRefGoogle Scholar

Copyright information

© Hospital for Special Surgery 2007

Authors and Affiliations

  • Keith M. Baumgarten
    • 1
  • Kate N. Meyers
    • 2
  • Stephen Fealy
    • 3
  • Timothy M. Wright
    • 2
  • Thomas L. Wickiewicz
    • 3
  1. 1.Sports Medicine and Shoulder Surgery SectionThe Orthopedic InstituteSioux FallsUSA
  2. 2.Department of Biomedical Mechanics and MaterialsThe Hospital for Special SurgeryNew YorkUSA
  3. 3.Department of Sports Medicine and Shoulder SurgeryThe Hospital for Special SurgeryNew YorkUSA

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