Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy.
Summary of "Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy."
The purpose of this study was to clarify the causes of the increase in the posterior tibial slope during open-wedge high tibial osteotomy (HTO) and to investigate whether its changes influenced the correction angle in frontal plane.
We retrospectively reviewed 20 patients (26 knees) treated with open-wedge HTO. They were divided into the following two groups. Group A consisted of the knees whose opening gaps were fixed using a spacer plate having the trapezoidal block with a 2° posterior slope. In Group B, anterior and posterior opening gaps were fixed separately. The posterior tibial slope and the hip-knee-ankle angle were measured based on CT data. The relationship between the correction rate in frontal plane and the changes of posterior tibial slope was investigated.
Increase in the posterior tibial slope was 2.1 ± 2.5° in Group A and 0.2 ± 1.2° in Group B, which showed a statistical difference (P = 0.02). The difference between the hip-knee-ankle angles before and after operation was 5.2 ± 2.3° in Group A and 5.5 ± 2.5° in Group B. The correction rate was statistically correlated with the changes of posterior tibial slope (R = -0.55, P = 0.003).
To avoid increase in the posterior tibial slope, the trapezoidal block with a only 2° posterior slope in a spacer plate was not sufficient, and it was necessary to fix anterior and posterior gaps separately. The correction angle in frontal plane had a trade-off relationship with the changes in posterior tibial slope. Thus, we thought that increase in the posterior tibial slope might result in correction loss. LEVEL OF
Therapeutic study, Retrospective comparative study, Level III.
Department of Orthopaedic Surgery, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama City, Osaka, 589-8511, Japan, firstname.lastname@example.org.
This article was published in the following journal.
Name: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21773829
- DOI: http://dx.doi.org/10.1007/s00167-011-1610-1
Medical and Biotech [MESH] Definitions
Disease or damage involving the SCIATIC NERVE, which divides into the PERONEAL NERVE and TIBIAL NERVE (see also PERONEAL NEUROPATHIES and TIBIAL NEUROPATHY). Clinical manifestations may include SCIATICA or pain localized to the hip, PARESIS or PARALYSIS of posterior thigh muscles and muscles innervated by the peroneal and tibial nerves, and sensory loss involving the lateral and posterior thigh, posterior and lateral leg, and sole of the foot. The sciatic nerve may be affected by trauma; ISCHEMIA; COLLAGEN DISEASES; and other conditions. (From Adams et al., Principles of Neurology, 6th ed, p1363)
Disease of the TIBIAL NERVE (also referred to as the posterior tibial nerve). The most commonly associated condition is the TARSAL TUNNEL SYNDROME. However, LEG INJURIES; ISCHEMIA; and inflammatory conditions (e.g., COLLAGEN DISEASES) may also affect the nerve. Clinical features include PARALYSIS of plantar flexion, ankle inversion and toe flexion as well as loss of sensation over the sole of the foot. (From Joynt, Clinical Neurology, 1995, Ch51, p32)
Tarsal Tunnel Syndrome
Entrapment of the distal branches of the posterior TIBIAL NERVE (which divides into the medial plantar, lateral plantar, and calcanial nerves) in the tarsal tunnel, which lies posterior to the internal malleolus and beneath the retinaculum of the flexor muscles of the foot. Symptoms include ankle pain radiating into the foot which tends to be aggravated by walking. Examination may reveal Tinel's sign (radiating pain following nerve percussion) over the tibial nerve at the ankle, weakness and atrophy of the small foot muscles, or loss of sensation in the foot. (From Foot Ankle 1990;11(1):47-52)
Posterior Tibial Tendon Dysfunction
A condition characterized by a broad range of progressive disorders ranging from TENOSYNOVITIS to tendon rupture with or without hindfoot collapse to a fixed, rigid, FLATFOOT deformity. Pathologic changes can involve associated tendons, ligaments, joint structures of the ANKLE, hindfoot, and midfoot. Posterior tibial tendon dysfunction is the most common cause of acquired flatfoot deformity in adults.
The anterior and posterior arteries created at the bifurcation of the popliteal artery. The anterior tibial artery begins at the lower border of the popliteus muscle and lies along the tibia at the distal part of the leg to surface superficially anterior to the ankle joint. Its branches are distributed throughout the leg, ankle, and foot. The posterior tibial artery begins at the lower border of the popliteus muscle, lies behind the tibia in the lower part of its course, and is found situated between the medial malleolus and the medial process of the calcaneal tuberosity. Its branches are distributed throughout the leg and foot.
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