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

HSS Journal


Thomas L. Wickiewicz, MD

Thomas L. Wickiewicz, MD

Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor of Clinical Orthopedic Surgery, Weill Cornell Medical College

Timothy Wright, PhD

Senior Scientist, Hospital for Special Surgery
F.M. Kirby Chair, Orthopaedic Biomechanics

Keith M. Baumgarten , MD
Orthopedic Institute, Sports Medicine and Shoulder Surgery Section, Sioux Falls, SD

Kate N. Meyers, MS
Hospital for Special Surgery, Department of Biomedical Mechanics and Materials

Stephen Fealy , MD
Hospital for Special Surgery, Department of Sports Medicine and Shoulder Surgery

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 5º, 10º, and 15º were performed.  The Qualisys Track Manager motion capture system was used to measure axial rotation.  Studentís 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 (1.2º internal rotation (IR) vs. 16º external rotation (ER) respectively at 5º correction; p = 0.02) (3.5º IR vs. 21.2º ER at 10º correction; p =0.04) (4.5º IR vs. 23.0º ER at 15º 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.

This article appears in HSS Journal: Volume 3, Number 2.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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