Acta Chir Orthop Traumatol Cech. 2006; 73(3):197-204 | DOI: 10.55095/achot2006/028

Medial Opening-Wedge High Tibial Valgus Osteotomy, Using a Stable TomoFix Plate, in Genu Varum Arthritis: Surgical TechniqueIn-service-training

D. HORÁČEK1,*, O. ČECH2, M. WEISSINGER3
1 Klinika dr. Pírka, s. r. o., Mladá Boleslav
2 Ortopedicko-traumatologická klinika 3. LF UK a FNKV, Praha
3 Orthopädische Schwerpunktabteilung des A. o. Krankenhauses, Zwetl, Österreich

The authors present the technique of high tibial correction osteotomy by the medial opening procedure, with the use of an angle-stable TomoFix plate. The prerequisite for a long-term good outcome of corrective osteotomy in genu varum is to achieve limb alignment permitting transfer of weight-bearing from the affected medial compartment to the healthy lateral compartment of the knee. The development of implants that maintain a stable angle has facilitated corrective osteotomy with an opening wedge on the medial side of the proximal tibia. These implants provide stable fixation even when a high correction of the mechanical axis is needed. The authors present the case of a patient with varus malalignment following a fracture of the tibia. In order to achieve correction of the limb's mechanical axis, it was necessary to open the proximal tibia osteotomy with a wedge that was 2.5 cm on the outer side.

Keywords: knee osteoarthritis, varus deformity, varus gonarthrosis, tibial osteotomy, open wedge, TomoFix

Accepted: March 20, 2006; Published: June 1, 2006  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
HORÁČEK D, ČECH O, WEISSINGER M. Medial Opening-Wedge High Tibial Valgus Osteotomy, Using a Stable TomoFix Plate, in Genu Varum Arthritis: Surgical Technique. Acta Chir Orthop Traumatol Cech. 2006;73(3):197-204. doi: 10.55095/achot2006/028. PubMed PMID: 16846566.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. AGLIETTI, P., BUZZI, R., VENA, L.M., BALDINI, A., MONDAINI, A.: High tibial valgus osteotomy for medial gonarthrosis: A 10- to 21-year study. J. Knee Surg., 16: 21-26, 2003.
    2. BROWN, G.A., AMENDOLA, A.: Radiographic evaluation and preoperative planning for high tibial osteotomies. Op. Tech. Sports Med., 8: 2-14, 2000. Go to original source...
    3. COVENTRY, M.B., ILSTRUP, D.M., WALLRICHS, S.L.: Proximal Tibial Osteotomy: A critical long-term Study of eighty-seven cases. J. Bone Jt Surg., 75-A: 196-201, 1993. Go to original source... Go to PubMed...
    4. COVENTRY, M.B.: Osteotomy of the Upper Portion of the Tibia for Degenerative Arthritis of the Knee. J. Bone Jt Surg., 47-A: 984-990, 1965. Go to original source...
    5. ČECH, O., STRYHAL, F.: Moderní osteosyntéza v traumatologii a ortopedii. Praha, Avicenum 1972.
    6. ČECH, O.: Stabilní osteosyntéza v traumatologii a ortopedii. Praha, Avicenum 1982.
    7. ČECH, O.: Přístup k proximálnímu konci tibie. In: Sosna, A., Čech, O.: Operační přístupy ke skeletu pohybového aparátu. Praha, Avicenum 1987.
    8. DUGDALE, T.W., NOYES, F.R., STYER, D.: Pre-operative planning for high tibial osteotomy. Clin. Orthop., 274: 248-264, 1992. Go to original source...
    9. FOWLER, P.J., TAN, J.L., BROWN, G.A.: Medial Opening Wedge High Tibial Osteotomy: How I Do It. Op. Tech. Sports Med., 8: 32-38, 2000. Go to original source...
    10. FRANCO, V., CERULLO, G., CIPOLLA, M., GIANNI, E., PUDDU, G.: Open Wedge High Tibial Osteotomy. Tech. Knee Surg., 1: 43-53, 2002. Go to original source...
    11. FUJISAWA, Y., MASUHARA, K., SHIOMI, S.: The Effect of High Tibial Osteotomy on Osteoarthritis of the Knee. Orthop. Clin. N. Amer., 10: 585-608, 1979. Go to original source...
    12. GAUTIER, E., THOMANN, B.W., BRANTSCHEN, R., JAKOB, R.P.: Fixation of high osteotomy with the AO cannulated knee plate. Acta orthop. scand., 70: 397-399, 1999. Go to original source... Go to PubMed...
    13. HERNIGOU, P., MEDEVIELLE, D., DEBEYRE, J., GOUTALLIER, D.: Proximal Tibial Osteotomy for Osteoarthritis with Varus Deformity. J. Bone Jt Surg., 69-A: 332-354, 1987. Go to original source...
    14. INSALL, J.N., DOUGLAS, M.J., MSIKA, C.: High Tibial Osteotomy for Varus Gonarthrosis A Long-Term Folow Up Study. J. Bone Jt Surg., 66-A: 1040-1048, 1984. Go to original source...
    15. JACKSON, J.P., WAUGH, W.W.: Tibial Osteotomy for Osteoarthritis of the Knee. J. Bone Jt Surg., 43-B: 746-751, 1961. Go to original source... Go to PubMed...
    16. KRBEC, M.: Osteotomie v oblasti kolenního kloubu. I. část-indikace a operační technika. Acta Chir. orthop. Traum. čech., 55: 481-490, 1988.
    17. LOBENHOFFER, P., AGNESKIRCHNER, J.D.: Improvements in surgical technique of valgus tibial osteotomy. Knee Surg. Sports Traum. Arthrosc., 11: 132-138, 2003. Go to original source... Go to PubMed...
    18. LOBENHOFFER, P., DE SIMONI, C., STAUBLI, A.E.: Open-Wedge High-Tibial Osteotomy With Rigid Plate Fixation. Tech. Knee Surg., 1: 93-105, 2002. Go to original source...
    19. MARTI, R.K., VERHAGEN, R.A.W.: Upper tibial osteotomy for osteoarthritis of the knee. In: Surgical Techniques in Orthopedics and Traumatology. Paris, Elsevier 2001.
    20. MINIACI, A., BALLMER, F.T., BALLMER, P.M., JAKOB, R.P.: Proximal tibial osteotomy. A new fixation device. Clin. Orthop., 246: 250-259, 1989. Go to original source...
    21. ONDROUCH, A., RYBKA, V.: Vysoká tibiální a dvojitá osteotomie kolena v léčbě revmatoidní artritidy. Acta Chir. orthop. Traum. čech., 40: 148-153, 1973.
    22. POD©KUBKA, A.: Gonartóza. In: DUNGL, P.: Ortopedie. Praha, Grada 2005.
    23. PRIX, R.: Opening wedge osteotomie proximální tibie. Acta Chir. orthop. Traum. čech., 72: 308-312, 2005.
    24. RYBKA, V.: Korekce deformit kolenního kloubu osteotomiemi a aloplastikou. Praha, Avicenum 1984.
    25. SGAGLIONE, N.A.: Update on the Approach to Osteotomies about the Knee. In: 24th Annual Meeting Arthroscopy Association of North America, Vancouver, 2005.
    26. SPRENGER, T.R., DOERZBACHER, J.F.: Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J. Bone Jt Surg., 85-A: 469-474, 2003. Go to original source...
    27. STAUBLI, A.E., DE SIMONI, C., BABST, R., LOBENHOFFER, P.: TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia - early results in 92 cases. Injury, 34(suppl. 2): S-B55-S-B62, 2003. Go to original source... Go to PubMed...
    28. STOFFEL, K., STACHOWIAK, G., KUSTER, M.: Open wedge high tibial osteotomy: Biomechanical investigation of the modified Arthrex osteotomy plate (Puddu plate) and the TomoFix plate. Clin. Biomech., 19: 944-950, 2004. Go to original source... Go to PubMed...
    29. VRZALA, J.: Korekční osteotomie bérce - srovnání dvou způsobů pooperačního léčení. Acta Chir. orthop. Traum. čech., 59: 229-234, 1992.
    30. WADA, M., IMURA, S., NAGATANI, K., BABA, H., SHIMADA, S., SASAKI, S.: Relationship between gait and clinical results after high tibial osteotomy. Clin. Orthop., 334: 180-188, 1998. Go to original source... Go to PubMed...
    31. WARDEN, S.J., MORRIS, H.G., CROSSLEY, K.M., BRUKNER, P.D., BENELL, K.L.: Delayed and non-union folowing opening wedge high tibial osteotomy: Surgeons results from 182 completed cases. Knee Surg. Sports Traum. Arthrosc., 13: 34-37, 2004. Go to original source... Go to PubMed...
    32. WEBER, B.G.: Semitubular Plate as a Tension Band. In: BRUNNER, CH.F., WEBER, B.G.: Special Techniques in Internal Fixation. Berlin, Heidelberg, New York, Springer-Verlag 1982.
    33. ZIMA, J.: Vysoká podstavná osteotomie tibie. Acta Chir. orthop. Traum. čech., 45: 58-64, 1978.

    Return to the content