The Effect of Hinge Position on Posterior Tibial Slope in Medial Open-Wedge High Tibial Osteotomy

Sang W on Moon, Sin H yung Park, Byung H oon Lee, Minkyung Oh, Minho Chang, Jin H wan Ahn, Joon H o Wang

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Abstract

PURPOSE: To evaluate whether hinge position affects the change in posterior tibial slope in medial open-wedge high tibial osteotomy (HTO).

METHODS: We retrospectively evaluated 19 knees from 17 patients who underwent medial open-wedge HTO by 3-dimensional computed tomography scan before and after surgery. A 3-dimensional image model was constructed by applying reverse-engineering software to the computed tomography DICOM (Digital Imaging and Communications in Medicine) files. The hinge axis (i.e., the position of the hinge compared with the anteroposterior axis on an axial view), posterior tibial slope, medial-proximal tibial angle, and gap ratio (i.e., the ratio of anterior gap to posterior gap in the opened wedge) were measured.

RESULTS: The mean hinge axis was 4.92° ± 3.86°. Posterior tibial slope increased from 7.29° ± 2.56° preoperatively to 10.48° ± 3.01° postoperatively (P = .001). The mean medial-proximal tibial angle was 85.96° ± 1.97° preoperatively and 93.13° ± 3.17° postoperatively (P = .001). The mean gap ratio was 62.48% ± 7.26%. Linear regression analysis determined that the hinge axis (P = .0001) was a significant factor changing posterior tibial slope.

CONCLUSIONS: Hinge position affected the change in posterior tibial slope in medial open-wedge HTO; in particular, a posterolateral hinge position led to an increase in posterior tibial slope.

LEVEL OF EVIDENCE: Level IV, therapeutic study.

Original languageEnglish
Pages (from-to)1128-1133
Number of pages6
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume31
Issue number6
DOIs
Publication statusPublished - 2015 Jun 1

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Osteotomy
Tomography
Linear Models
Knee
Software
Communication
Regression Analysis
Medicine
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The Effect of Hinge Position on Posterior Tibial Slope in Medial Open-Wedge High Tibial Osteotomy. / Moon, Sang W on; Park, Sin H yung; Lee, Byung H oon; Oh, Minkyung; Chang, Minho; Ahn, Jin H wan; Wang, Joon H o.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 31, No. 6, 01.06.2015, p. 1128-1133.

Research output: Contribution to journalArticle

Moon, Sang W on ; Park, Sin H yung ; Lee, Byung H oon ; Oh, Minkyung ; Chang, Minho ; Ahn, Jin H wan ; Wang, Joon H o. / The Effect of Hinge Position on Posterior Tibial Slope in Medial Open-Wedge High Tibial Osteotomy. In: Arthroscopy - Journal of Arthroscopic and Related Surgery. 2015 ; Vol. 31, No. 6. pp. 1128-1133.
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N2 - PURPOSE: To evaluate whether hinge position affects the change in posterior tibial slope in medial open-wedge high tibial osteotomy (HTO).METHODS: We retrospectively evaluated 19 knees from 17 patients who underwent medial open-wedge HTO by 3-dimensional computed tomography scan before and after surgery. A 3-dimensional image model was constructed by applying reverse-engineering software to the computed tomography DICOM (Digital Imaging and Communications in Medicine) files. The hinge axis (i.e., the position of the hinge compared with the anteroposterior axis on an axial view), posterior tibial slope, medial-proximal tibial angle, and gap ratio (i.e., the ratio of anterior gap to posterior gap in the opened wedge) were measured.RESULTS: The mean hinge axis was 4.92° ± 3.86°. Posterior tibial slope increased from 7.29° ± 2.56° preoperatively to 10.48° ± 3.01° postoperatively (P = .001). The mean medial-proximal tibial angle was 85.96° ± 1.97° preoperatively and 93.13° ± 3.17° postoperatively (P = .001). The mean gap ratio was 62.48% ± 7.26%. Linear regression analysis determined that the hinge axis (P = .0001) was a significant factor changing posterior tibial slope.CONCLUSIONS: Hinge position affected the change in posterior tibial slope in medial open-wedge HTO; in particular, a posterolateral hinge position led to an increase in posterior tibial slope.LEVEL OF EVIDENCE: Level IV, therapeutic study.

AB - PURPOSE: To evaluate whether hinge position affects the change in posterior tibial slope in medial open-wedge high tibial osteotomy (HTO).METHODS: We retrospectively evaluated 19 knees from 17 patients who underwent medial open-wedge HTO by 3-dimensional computed tomography scan before and after surgery. A 3-dimensional image model was constructed by applying reverse-engineering software to the computed tomography DICOM (Digital Imaging and Communications in Medicine) files. The hinge axis (i.e., the position of the hinge compared with the anteroposterior axis on an axial view), posterior tibial slope, medial-proximal tibial angle, and gap ratio (i.e., the ratio of anterior gap to posterior gap in the opened wedge) were measured.RESULTS: The mean hinge axis was 4.92° ± 3.86°. Posterior tibial slope increased from 7.29° ± 2.56° preoperatively to 10.48° ± 3.01° postoperatively (P = .001). The mean medial-proximal tibial angle was 85.96° ± 1.97° preoperatively and 93.13° ± 3.17° postoperatively (P = .001). The mean gap ratio was 62.48% ± 7.26%. Linear regression analysis determined that the hinge axis (P = .0001) was a significant factor changing posterior tibial slope.CONCLUSIONS: Hinge position affected the change in posterior tibial slope in medial open-wedge HTO; in particular, a posterolateral hinge position led to an increase in posterior tibial slope.LEVEL OF EVIDENCE: Level IV, therapeutic study.

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