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. 2021 Jan 18;22(1):89.
doi: 10.1186/s12891-021-03951-0.

The effect of the sagittal plane osteotomy inclination on the posterior tibial slope in medial open wedge HTO: experimental study with a square column model

Sang Won Moon  1 , Ji Young Ryu  2 , Sung-Jae Lee  3 , Sang Won Woo  3 , Sin Hyung Park  4 , Young Choi  5
Affiliations

The effect of the sagittal plane osteotomy inclination on the posterior tibial slope in medial open wedge HTO: experimental study with a square column model

Sang Won Moon et al. BMC Musculoskelet Disord. .

Erratum in

Abstract

Background: Medial open-wedge high tibial osteotomy (HTO) is an effective and safe treatment method for medial osteoarthritis of the knee. However, unintended changes in the posterior tibial slope (PTS) may occur. Several factors cause PTS alterations after medial open-wedge HTO; however, research on sagittal-plane osteotomy inclination (SPOI) in relation to the PTS is sparse. The purpose of this study was to evaluate whether the SPOI affects changes in the PTS after medial open-wedge HTO. The hypothesis was that an SPOI parallel to the PTS causes no change in the PTS after medial open-wedge HTO.

Methods: A square column model with a 10° posterior slope was produced using two three-dimensional (3D) programs and a 3D printer. Then, a series of medial open-wedge HTO procedures was performed on the square column model through virtual simulation using the two 3D programs, and an actual simulation was conducted using a 3D printer, a testing machine and a measurement system. The SPOI was divided into four types: ① SPOI 20° (posterior-inclined 10° osteotomy), ② SPOI 10° (osteotomy parallel to posterior slope), ③ SPOI 0° (anterior-inclined 10° osteotomy), and ④ SPOI - 10° (anterior-inclined 20° osteotomy). The correction angle was increased at intervals of 5° from 0° to 30°. The change in posterior slope was measured in the sagittal plane.

Results: The posterior slope was increased in SPOI 20° (posterior-inclined 10° osteotomy), maintained in SPOI 10° (osteotomy parallel to posterior slope), and decreased in SPOI 0° (anterior-inclined 10° osteotomy) and SPOI - 10° (anterior-inclined 20° osteotomy) based on the correction angle.

Conclusions: In this study using a square column model, the SPOI affected the change in the PTS, and an SPOI parallel to the PTS caused no change in the PTS after medial open-wedge HTO.

Keywords: High tibial osteotomy; Osteotomy; Posterior slope; Posterior tibia slope; Simulation; Tibia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a A square column model with a 10° posterior slope. b Medial view of the square column model
Fig. 2
Fig. 2
a Four square column models with jigs attached at different angles. b After correction with the MTS 858 Bionix machine (MTS System Corp), the end-point of the posterior slope was measured using a MicroScribe™ system (Revware Systems, Inc.). c The change in posterior slope was determined using Rhinoceros® software (McNeel)
Fig. 3
Fig. 3
Changes in posterior slope during virtual simulation with SPOI 20° (a), SPOI 10° (b), SPOI: 0° (c), and SPOI -10° (d)
Fig. 4
Fig. 4
Changes in posterior slope based on sagittal plane osteotomy inclination (SPOI) in the actual simulation
Fig. 5
Fig. 5
Mathematic modeling of SPOI 0° (anterior-inclined 10° osteotomy). a Before correction; b After correction; P1: anterior end point; P2: posterior end point; H1: anterior end point of the lateral hinge; H2: posterior end point of the lateral hinge; r1: distance from H1 to P1; r2: distance from H2 to P2; θ1: angle of P1 with the OP line; θ2: angle of P2 with the OP line; ϰ1=r1xsin(θ1); ϰ2=r2xsin(θ2); ϰ1′=r1xsin(θ1 + θ); ϰ2′=r2xsin(θ2 + θ)
See this image and copyright information in PMC

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