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Patients specific cutting guides are helpful tools from simple to complex intra-articular high tibial osteotomies

Published in N°010 - March / April 2021
Article viewed 107 times

Patients specific cutting guides are helpful tools from simple to complex intra-articular high tibial osteotomies

By Christophe Jacquet(1,2), Philippe Berton(3), Mathias Donnez(3), Akash Sharma(1), Kristian Kley(2,4), Adrian Wilson(2,4) , Simone Cerciello(1), Sébastien Parratte(1,2), Matthieu Ollivier(1,2) in category SURGICAL TECHNIQUE
(1) Institute of movement and locomotion Department of Orthopedics and Traumatology, St Marguerite Hospital, 270 Boulevard Sainte Marguerite, BP 29 13274 Marseille, France. - (2) Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopedics and Traumatology, Marseille, France. - (3) Newclip Techniques, Haute Goulaine, France. - (4) The Wellington Hospital, Wellington Place, St. John’s Wood, London, UK.

The aim of medial opening-wedge and lateral closing tibial osteotomies is to correct varus alignment in the lower limb to treat overload in the medial compartment of the knee joint. In the last decade, medial opening-wedge high tibial osteotomy (OW-HTO) has gained increasing popularity, as more and more studies continue to report good post-operative outcomes with fewer complications.

Introduction

The aim of medial opening-wedge and lateral closing tibial osteotomies is to correct varus alignment in the lower limb to treat overload in the medial compartment of the knee joint [1,2]. In the last decade, medial opening-wedge high tibial osteotomy (OW-HTO) has gained increasing popularity, as more and more studies continue to report good post-operative outcomes with fewer complications [2]. Accurate correction in all three spatial planes is a pivotal factor to obtain good clinical outcomes [3]. To achieve the ideal planned correction, various planning methods, surgical techniques using different instrumentations have been developed. This includes conventional methods (with various intraoperative techniques to assess lower-limb alignment), computer-assisted surgery [4,5] and recently the use of patient-specific cutting guides (PSCG) [6–8]. We started using PSCG in 2015 [9] and recently published 2 years results of our 100 first patients [10], as well as our learning curve using this philosophy in regular OW-HTO [11].

Our experience drove us to a better understanding of Maths and Biomechanical basis of osteotomies thanks to the extensive 3D planning and virtual osteotomy prior to the surgery. Thus, we challenged ourselves to perform more and more complex...

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