Posts

Ultrasonic Bone Scalpel and Its Role In Spine Surgeries : An Article Review

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 20-27| TausifAhmed Shikalgar, Priyank Patel, Abhay Nene, Shubhanshu Bhaladhare, Sanjay Puri, Manojkumar Gaddiker

DOI:10.13107/jcorth.2022.v07i01.461


Author: TausifAhmed Shikalgar [1], Priyank Patel [1], Abhay Nene [1], Shubhanshu Bhaladhare [1], Sanjay Puri [1], Manojkumar Gaddiker [1]

[1] Department of Orthopaedics, Lilavati Hospital and Research Centre, Bandra (W), Mumbai 400050, India

 

Address of Correspondence
Dr. Tausif Ahmed Shikalgar,
Fellow Spine Surgery, Under Dr. Abhay Nene, Lilavati Hospital and Research Centre, Bandra (W), Mumbai – 400 050, Maharashtra, India.
E-mail: Dr.tausifahmedshikalgar@gmail.com


Abstract

The past few decades have seen tremendous improvement in the field of spine surgery. Spine surgery involves a number of procedures from simple laminectomy to deformity correction. This requires high surgical skills and care, which is achieved by a number of instruments, which, in turn, protect surgeons from committing complications. Recent advancements in spine surgery include ultrasonic bone scalpel, which cut bone accurately and precisely. It is a unique surgical device which offers a controlled osteotomy which slices the hard bone while the soft tissues remain largely unaffected. The major benefits of using this modern instrument are the soft-tissue sparing, controlled cutting, reduced bleeding, and thereby increasing the effectiveness. The aim of this article is to summarize its uses in current practice of spine surgeons and to focus on its advantages and complications associated with uses of this device.

Keywords: Ultrasonic bone scalpel, spine surgery, complications, safety, osteotomy


References

  1. Walker CT, Kakarla UK, Chang SW, Sonntag VK. History and advances in spinal neurosurgery. J Neurosurg Spine 2019;31:775-85.
  2. Grochulla F, Vieweg U. Surgical motor systems in spinal surgery. In: Vieweg U, Grochulla F, editors. Manual of Spine Surgery. Berlin, Heidelberg: Springer Berlin Heidelberg; 2012. p. 69-74.
  3. Bydon M, Macki M, Xu R, Ain MC, Ahn ES, Jallo GI. Spinal decompression in achondroplastic patients using high-speed drill versus ultrasonic bone curette: Technical note and outcomes in 30 cases. J Pediatr Orthop 2014;34:780-6.
  4. Nasser R, Yadla S, Maltenfort MG, Harrop JS, Anderson DG, Vaccaro AR, et al. Complications in spine surgery. J Neurosurg Spine 2010;13:14457.
  5. Ratliff JK, Lebude B, Albert T, Anene-Maidoh T, Anderson G, Dagostino P, et al. Complications in spinal surgery: Comparative survey of spine surgeons and patients who underwent spinal surgery. J Neurosurg Spine 2009;10:578-84.
  6. Nakase H, Matsuda R, Shin Y, Park YS, Sakaki T. The use of ultrasonic bone curettes in spinal surgery. Acta Neurochir 2006;148:207-12; discussion 212-3.
  7. Nakagawa H, Kim SD, Mizuno J, Ohara Y, Ito K. Technical advantages of an ultrasonic bone curette in spinal surgery. J Neurosurg Spine 2005;2:431-5.
  8. Pakzaban P. BoneScalpelTM Ultrasonic Bone Cutting System: Neurosurgical and Orthopaedic Applications, Aesculap Power Systems; 2012.
  9. BoneScalpel TM Ultrasonic Bone Dissector: Applications in Spine Surgery and Surgical Technique Guide.
  10. Moon RD, Srikandarajah N, Clark S, Wilby MJ, Pigott TD. Primary lumbar decompression using ultrasonic bone curette compared to conventional technique. Br J Neurosurg 2021;35:775-9.
  11. Hu X, Ohnmeiss DD, Lieberman IH. Use of an ultrasonic osteotome device in spine surgery: Experience from the first 128 patients. Eur Spine J 2013;22:2845-9.
  12. Hazer DB, Yaşar B, Rosberg HE, Akbaş A. Technical aspects on the use of ultrasonic bone shaver in spine surgery: Experience in 307 patients. Biomed Res Int 2016;2016:8428530.
  13. Bydon M, Xu R, Papademetriou K, Sciubba DM, Wolinsky JP, Witham TF, et al. Safety of spinal decompression using an ultra-sonic bone curette compared with a high-speed drill: Outcomes in 337 patients. J Neurosurg Spine 2013;18:627-33.
  14. Al-Mahfoudh R, Mitchell PS, Wilby M, Crooks D, Barrett C, Pillay R, et al. Management of giant calcified thoracic disks and description of the trench vertebrectomy technique. Glob Spine J 2016;6:584-91.
  15. Dave BR, Krishnan A, Rai RR, Degulmadi D, Mayi S, Gudhe M. The effectiveness and safety of ultrasonic bone scalpel versus conventional method in cervical laminectomy: A retrospective study of 311 patients. Glob Spine J 2020;10:760-6.
  16. Li K, Zhang W, Li B, Xu H, Li Z, Luo D, et al. Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill. Medicine (Baltimore) 2016;95:e4913.
  17. Onen MR, Yuvruk E, Akay S, Naderi S, The reliability of the ultrasonic bone scalpel in cervical spondylotic myelopathy: A comparative study of 46 patients. World Neurosurg 2015;84:1962-7.
  18. Al-Mahfoudh R, Qattan E, Ellenbogen JR, Wilby M, Barrett C, Pigott T. Applications of the ultrasonic bone cutter in spinal surgery our preliminary experience. Br J Neurosurg 2014;28:56-60.
  19. Shousha M, El-Saghir H, Boehm H. Corpectomy of the fifth lumbar vertebra, a challenging procedure. J Spinal Disord Tech 2014;27:347-51.
  20. Hu SS. Blood loss in adult spinal surgery. Eur Spine J 2004;13Suppl 1:S3-5.
  21. Dave BR, Degulmadi D, Dahibhate S, Krishnan A, Patel D. Ultrasonic bone scalpel: Utility in cervical corpectomy. A technical note. Eur Spine J 2019;28:380-5.
  22. Jenis LG, An HS. Spine update. Lumbar foraminal stenosis. Spine 2000;25:389-94.
  23. Morimoto D, Isu T, Kim K, Sugawara A, Matsumoto R, Isobe M. Microsurgical medial fenestration with an ultrasonic bone curette for lumbar foraminal stenosis. J Nippon Med Sch 2012;79:327-34.
  24. Chen HT, Hsu CC, Lu ML, Chen SH, Chen JM, Wu RW. Effects of combined use of ultrasonic bone scalpel and hemostatic matrix on perioperative blood loss and surgical duration in degenerative thoracolumbar spine surgery. Biomed Res Int 2019;2019:6286528.
  25. Hamburger C. T-laminoplasty-a surgical approach for cervicalspondylotic myelopathy. Technical note. Acta Neurochir  1995;132:131-3.
  26. Herman JM, Sonntag VK. Cervical corpectomy and plate fixation for postlaminectomy kyphosis. J Neurosurg 1994;80:963-70.
  27. Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 1983;8:693-9.
  28. Ito K, Ishizaka S, Sasaki T, Miyahara T, Horiuchi T, Sakai K, et al. Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: Technical note. Surg Neurol 2009;72:470-5 discussion 475.
  29.  Park AE, Heller JG. Cervical laminoplasty: Use of a novel titanium plate to maintain canal expansion-surgical technique. J Spinal Disord Tech 2004;17:265-71.
  30. Matsuoka H, Itoh Y, Numazawa S, Tomii M, Watanabe K, Hirano Y, et al. Recapping hemilaminoplasty for spinal surgical disorders using ultrasonic bone curette. Surg Neurol Int 2012;3:70.
  31. Parker SL, Kretzer RM, Recinos PF, Molina CA, Wolinsky JP, Jallo GI, et al. Ultrasonic BoneScalpel for osteoplastic laminoplasty in the resection of intradural spinal pathology: Case series and technical note. Neurosurgery 2013;73 Suppl Operative 1:ons61-6.
  32. Barbanera A, Serchi E, Fiorenza V, Nina P, Andreoli A. Giant calcified thoracic herniated disc: Considerations aiming a proper surgical strategy. J Neurosurg Sci 2009;53:19-25 discussion 25-6.
  33. Okada Y, Shimizu K, Ido K, Kotani S. Multiple thoracic disc herniations: Case report and review of the literature. Spinal Cord 1997;35:183-6.
  34. Cornips EM, Janssen ML, Beuls EA. Thoracic disc herniation and acute myelopathy: Clinical presentation, neuroimaging findings, surgical considerations, and outcome. J Neurosurg. Spine 2011;14:520-8.
  35. Hott JS, Feiz-Erfan I, Kenny K, Dickman CA. Surgical management of giant herniated thoracic discs: Analysis of 20 cases. J  eurosurg Spine 2005;3:191-7.
  36. Wahlquist S, Nelson S, Glivar P. Effect of the ultrasonic bone scalpel on blood loss during pediatric spinal deformity correction surgery. Spine Deform 2019;7:582-7.
  37. Garg S, Thomas J, Darland H, Kim E, Kittelson J, Erickson M, et al. Ultrasonic bone scalpel (USBS) does not reduce blood loss during posterior spinal fusion (PSF) in patients with adolescent idiopathic scoliosis (AIS): Randomized clinical trial. Spine (Phila Pa 1976) 2021;46:845-51.
  38. Kim K, Isu T, Matsumoto R, Isobe M, Kogure K. Surgical pitfalls of an ultrasonic bone curette (Sonopet) in spinal surgery. Oper Neurosurg 2006;59 Suppl 4:ONS-390; discussion ONS393.
  39. Brooks AT, Nelson CL, Stewart CL, Skinner RA, Siems ML. Effect of an ultrasonic device on temperatures generated in bone and on bone-cement structure. J Arthroplast 1993;8:413-8.
  40. Gleizal A, Bera JC, Lavandier B, Beziat JL. Piezoelectric osteotomy: A new technique for bone surgery advantages in craniofacial surgery. Childs Nerv Syst 2007;23:509-13.

 

How to Cite this article: Shikalgar TA, Patel P, Nene A, Bhaladhare S, Puri S, Gaddikeri M. Ultrasonic Bone Scalpel and its Role in Spine Surgeries: An Article Review. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):20-27.

 (Abstract    Full Text HTML)   (Download PDF)


Current Concepts in High Tibial Osteotomy

Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page:24-31 | Vikram Arun Mhaskar, Yogesh Jain, Jitendra Maheshwari


Author: Vikram Arun Mhaskar [1], Yogesh Jain [1], Jitendra Maheshwari [1]

[1] Knee & Shoulder Clinic, New Delhi, Max Superspecilaity Hospital Saket, New Delhi, India

Address of Correspondence
Dr. Vikram Arun Mhaskar,
Knee & Shoulder Clinic, New Delhi, Max Superspecilaity Hospital Saket, New Delhi, India
E-mail: drvikrammhaskar@gmail.com


Abstract

Background: High tibial osteotomy is an effective procedure for the management of medial compartment osteoarthritis. This paper intends to analyze the current indications, contra indications, technique, complications, survival, and recent advances of this procedure.

Method: Literature review was done by searching journals with “High tibial osteotomy,” “Indications of HTO,” “Alignment in HTO,” “Survival and clinical outcomes of HTO,” and “Recent advances in HTO.” A total of 12 articles were found suitable for this study and reviewed.

Outcomes: Indications have largely remained the same except for thrust, which was earlier, a contra indication, Biplanar osteotomy, patient specific instrumentation; 3D printing and computer navigation are the recent technical modifications. The rate of complications is variable in different studies and the 5-year survival is still over 90% in most studies. Rate of serious complications is low but minor complications are high.

Conclusion: HTO is a successful procedure in treating medial compartment OA in isolation or with ligament deficiencies with a good 5 and 10-year survival. Recent advances have focused on improving planning, rehabilitation, and accuracy of alignment.

Keywords: High Tibial Osteotomy, osteotomy, deformity, gene varum, osteoarthritis, knee preservation, deformity correction


References

  1. Takeuchi R, Umemoto Y, Aratake M, Bito H, Saito I, Kumagai K, Sasaki Y, Akamatsu Y, Ishikawa H, Koshino T, Saito T. A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee. Journal of Orthopaedic Surgery and Research. 2010 Dec;5(1):65.
  2. Petersen W, Metzlaff S. Open wedge high tibial osteotomy (HTO) versus mobile bearing unicondylar medial joint replacement: five years results. Archives of orthopaedic and trauma surgery. 2016 Jul 1;136(7):983-9.
  3. Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE. High tibial osteotomy. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2005 Jul 1;13(4):279-89.
  4. Brouwer RW, Bierma-Zeinstra SM, Van Koeveringe AJ, Verhaar JA. Patellar height and the inclination of the tibial plateau after high tibial osteotomy: the open versus the closed-wedge technique. The Journal of bone and joint surgery. British volume. 2005 Sep;87(9):1227-32.
  5. . Figueroa F, Mhaskar V, Scholes C, Pearlman A, Coolican M, Parker D, Fritsch B. Symptomatic relief in medial opening wedge high tibial osteotomies for the treatment of knee osteoarthritis is influenced by concurrent procedures and preoperative pain level. Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine. 2018 Jan 1;3(1):8-16.
  6. Sabzevari S, Ebrahimpour A, Roudi MK, Kachooei AR. High tibial osteotomy: a systematic review and current concept. Archives of Bone and Joint Surgery. 2016 Jun;4(3):204.
  7. Pape D, Kohn D, Van Giffen N, Hoffmann A, Seil R, Lorbach O. Differences in fixation stability between spacer plate and plate fixator following high tibial osteotomy. Knee surgery, sports traumatology, arthroscopy. 2013 Jan 1;21(1):82-9.
  8. Kim JH, Kim HJ, Lee DH. Survival of opening versus closing wedge high tibial osteotomy: a meta-analysis. Scientific Reports. 2017 Aug 4;7(1):1-7.
  9. Mhaskar VA, Maheshwari J, Ugrasen H. Bilateral HTO in same sitting: Perioperative challenge or feasible option?. Journal of Arthroscopy and Joint Surgery. 2020 Apr 1;7(2):69-73. 16.
  10. Rand JA, Neyret P. ISAKOS meeting on the management of osteoarthritis of the knee prior to total knee arthroplasty. In ISAKOS congress 2005
  11. Flecher X, Parratte S, Aubaniac JM, Argenson JN. A12-28-year followup study of closing wedge high tibial osteotomy. Clinical Orthopaedics and Related Research®. 2006 Nov 1;452:91-6.
  12. Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. The Install Award. Survivorship of the high tibial valgus osteotomy. A10-to[1]22-year followup study. Clinical orthopaedics and related research. 1999 Oct(367):18-27.
  13. Michaela G, Florian P, Michael L, Christian B. Long-term outcome after high tibial osteotomy. Archives of orthopaedic and trauma surgery. 2008 Jan 1;128(1):111-5.
  14. Aglietti P, Rinonapoli EM, Stringa GA, Taviani AN. Tibial osteotomy for the varus osteoarthritic knee. Clinical orthopaedics and related research. 1983 Jun(176):239-51.
  15. Ivarsson IN, Myrnerts RU, Gillquist J. High tibial osteotomy for medial osteoarthritis of the knee. A5 to 7 and 11 year follow-up. The Journal of bone and joint surgery. British volume. 1990 Mar;72(2):238-44.
  16. RUDAN JF, SIMURDAMA. High tibial osteotomy: a prospective clinical and roentgenographic review. Clinical Orthopaedics and Related Research®. 1990 Jun 1;255:251-6.
  17. Insall JN, Joseph DM, Msika C. High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. The Journal of bone and joint surgery. American volume. 1984 Sep;66(7):1040-8.
  18. Stuchin SA, Johanson NA, Lachiewicz PF, Mont MA. Surgical management of inflammatory arthritis of the adult hip and knee. Instructional course lectures. 1999;48:93-109
  19. Markolf KL, Bargar WL, Shoemaker SC, Amstutz HC. The role of joint load in knee stability. JBJS. 1981 Apr 1;63(4):570-85.
  20. Lee DC, Byun SJ. High tibial osteotomy. Knee surgery & related research. 2012 Jun;24(2):61.
  21. Murphy SB. Tibial osteotomy for genu varum. Indications, preoperative planning, and technique. The Orthopedic Clinics of North America. 1994 Jul 1;25(3):477-82.
  22. Solayar GN, Chinappa J, Harris IA, Chen DB, Macdessi SJ. A comparison of plain radiography with computer tomography in determining coronal and sagittal alignments following total knee arthroplasty. Malaysian Orthopaedic Journal. 2017 Jul;11(2):45.
  23. Müller M, Strecker W. Arthroscopy prior to osteotomy around the knee?. Archives of orthopaedic and trauma surgery. 2008 Nov 1;128(11):1217-21.
  24. Friemert B, Oberländer Y, Danz B, Häberle HJ, Bähren W, Gerngross H, Schwarz W. MRI vs. arthroscopy in the diagnosis of cartilage lesions in the knee. Can MRI take place of arthroscopy?. Zentralblatt fur Chirurgie. 2002 Oct 1;127(10):822-7.
  25. Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H. The long-term outcome of high tibial osteotomy: a ten-to 20- year follow-up. The Journal of Bone and Joint Surgery. British volume. 2008 May;90(5):592-6
  26. Berman AT, Bosacco SJ, Kirshner ST, Avolio Jr A. Factors influencing long-term results in high tibial osteotomy. Clinical orthopaedics and related research. 1991 Nov 1(272):192-8. 28. Bonnin M, Chambat P. Current status of valgus angle, tibial head closing wedge osteotomy in media gonarthrosis. Der Orthopade. 2004 Feb;33(2):135-42.
  27. Niemeyer P, Schmal H, Hauschild O, von Heyden J, Südkamp NP, Köstler W. Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2010 Dec 1;26(12):1607-16.
  28. Bonnin M, Chambat P. Current status of valgus angle, tibial head closing wedge osteotomy in media gonarthrosis. Der Orthopade. 2004 Feb;33(2):135-42.
  29. Jenny JY, Tavan A, Jenny G, Kehr P. Long-term survival rate of tibial osteotomies for valgus gonarthrosis. Revue de chirurgie orthopedique et reparatrice de l’appareil moteur. 1998 Jul;84(4):350-7.
  30. Brinkman JM, Lobenhoffer P, Agneskirchner JD, Staubli AE, Wymenga AB, Van Heerwaarden RJ. Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. The Journal of bone and joint surgery. British volume. 2008 Dec;90(12):1548-57.
  31. Coventry MB. Osteotomy about the knee for degenerative and rheumatoid arthritis: indications, operative technique, and results. JBJS. 1973 Jan 1;55(1):23-48.
  32. Odenbring S, Tjörnstrand B, Egund N, Hagstedt B, Hovelius L, Lindstrand A, Luxhöj T, Svanström A. Function after tibial osteotomy for medial gonarthrosis below aged 50 years. Acta orthopaedica Scandinavica. 1989 Jan 1;60(5):527-31.
  33. Bellemans J, Colyn W, Vandenneucker H, Victor J. The Chitranjan Ranawat Award: is neutral mechanical alignment normal for all patients?: the concept of constitutional varus. Clinical Orthopaedics and Related Research®. 2012 Jan 1;470(1):45-53.
  34. Schipplein OD, Andriacchi TP. Interaction between active and passive knee stabilizers during level walking. Journal of orthopaedic research. 1991 Jan;9(1):113-9.
  35. Halder A, Kutzner I, Graichen F, Heinlein B, Beier A, Bergmann G. Influence of limb alignment on mediolateral loading in total knee replacement: in vivo measurements in five patients. JBJS. 2012 Jun 6;94(11):1023-9.
  36. Dugdale TW, Noyes FR, Styer DA. Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clinical orthopaedics and related research. 1992 Jan(274):248-64.
  37. Jung WH, Takeuchi R, Chun CW, Lee JS, Ha JH, Kim JH, Jeong JH. Second-look arthroscopic assessment of cartilage regeneration after medial opening-wedge high tibial osteotomy. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2014 Jan 1;30(1):72-9.
  38. Kanamiya T, Naito M, Hara M, Yoshimura I. The influences of biomechanical factors on cartilage regeneration after high tibial osteotomy for knees with medial compartment osteoarthritis: clinical and arthroscopic observations. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2002 Sep 1;18(7):725-9.
  39. Madry H, Kon E, Condello V, Peretti GM, Steinwachs M, Seil R, Berruto M, Engebretsen L, Filardo G, Angele P. Early osteoarthritis of the knee. Knee Surgery, Sports Traumatology, Arthroscopy. 2016 Jun 1;24(6):1753-62.
  40. Tischer T, Paul J, Pape D, Hirschmann MT, Imhoff AB, Hinterwimmer S, Feucht MJ. The impact of osseous malalignment and realignment procedures in knee ligament surgery: a systematic review of the clinical evidence. Orthopaedic journal of sports medicine. 2017 Mar 24;5(3):2325967117697287.
  41. Kim KI, Seo MC, Song SJ, Bae DK, Kim DH, Lee SH. Change of chondral lesions and predictive factors after medial open[1]wedge high tibial osteotomy with a locked plate system. The American Journal of Sports Medicine. 2017 Jun;45(7):1615-21.
  42. Krych AJ, Hevesi M, Desai VS, Camp CL, Stuart MJ, Saris DB. Learning from failure in cartilage repair surgery: An analysis of the mode of failure of primary procedures in consecutive cases at a tertiary referral center. Orthopaedic journal of sports medicine. 2018 May 9;6(5):2325967118773041.
  43. Giffin JR, Shannon FJ. The role of the high tibial osteotomy in the unstable knee. Sports medicine and arthroscopy review. 2007 Mar 1;15(1):23-31.
  44. Badhe NP, Forster IW. High tibial osteotomy in knee instability: the rationale of treatment and early results. Knee Surgery, Sports Traumatology, Arthroscopy. 2002 Jan 1;10(1):38-43.
  45. Voos JE, Suero EM, Citak M, Petrigliano FP, Bosscher MR, Citak M, Wickiewicz TL, Pearle AD. Effect of tibial slope on the stability of the anterior cruciate ligament–deficient knee. Knee Surgery, Sports Traumatology, Arthroscopy. 2012 Aug 1;20(8):1626-31.
  46. Lee SH, Lee OS, Teo SH, Lee YS. Change in gait after high tibial osteotomy: Asystematic review and meta-analysis. Gait & posture. 2017 Sep 1;57:57-68.
  47. Marriott KA, Birmingham TB, Giffin RJ, Jones IC. Gait biomechanics pre and post combined high tibial osteotomy and acl reconstruction. Osteoarthritis and Cartilage. 2014 Apr 1;22:S112-3.
  48. Leitch KM, Birmingham TB, Dunning CE, Giffin JR. Medial opening wedge high tibial osteotomy alters knee moments in multiple planes during walking and stair ascent. Gait & posture. 2015 Jul 1;42(2):165-71.
  49. Liu X, Chen Z, Gao Y, Jin Z. High tibial osteotomy: review of techniques and biomechanics. Journal of healthcare engineering. 2019 May 2;2019.
  50. Ekhtiari S, Haldane CE, Simunovic N, Musahl V, Ayeni OR. Return to work and sport following high tibial osteotomy: a systematic review. JBJS. 2016 Sep 21;98(18):1568-77.
  51. Park CH, Bae DK, Kim KI, Lee JW, Song SJ. Serial changes in the joint space width and joint line convergence angle after closed-wedge high tibial osteotomy. American J Sports Med 2017 Dec;45(14):3254-61.
  52. DeMeo PJ, Johnson EM, Chiang PP, Flamm AM, Miller MC. Midterm follow-up of opening-wedge high tibial osteotomy. The American journal of sports medicine. 2010 Oct;38(10):2077- 84.
  53. Amzallag J, Pujol N, Maqdes A, Beaufils P, Judet T, Catonne Y. Patellar height modification after high tibial osteotomy by either medial opening-wedge or lateral closing-wedge osteotomies. Knee Surgery, Sports Traumatology, Arthroscopy. 2013 Jan 1;21(1):255-9.
  54. Bae DK, Song SJ, Kim HJ, Seo JW. Change in limb length after high tibial osteotomy using computer-assisted surgery: a comparative study of closed-and open-wedge osteotomies. Knee Surgery, Sports Traumatology, Arthroscopy. 2013 Jan 1;21(1):120-6.
  55. Hankemeier S, Mommsen P, Krettek C, Jagodzinski M, Brand J, Meyer C, Meller R. Accuracy of high tibial osteotomy: comparison between open-and closed-wedge technique. Knee Surgery, Sports Traumatology, Arthroscopy. 2010 Oct 1;18(10):1328-33.
  56. Ducat A, Sariali E, Lebel B, Mertl P, Hernigou P, Flecher X, Zayni R, Bonnin M, Jalil R, Amzallag J, Rosset P. Posterior tibial slope changes after opening-and closing-wedge high tibial osteotomy: a comparative prospective multicenter study. Orthopaedics & Traumatology: Surgery & Research. 2012 Feb 1;98(1):68-74.
  57. Georgoulis AD, Makris CA, Papageorgiou CD, Moebius UG, Xenakis T, Soucacos PN. Nerve and vessel injuries during high tibial osteotomy combined with distal fibular osteotomy: a clinically relevant anatomic study. Knee Surgery, Sports Traumatology, Arthroscopy. 1999 Sep 1;7(1):15-9.
  58. Lee DC, Byun SJ. High tibial osteotomy. Knee surgery & related research. 2012 Jun;24(2):61.
  59. Robin JG, Neyret P. High tibial osteotomy in knee laxities: concepts review and results. EFORT open reviews. 2016 Jan;1(1):3-11.
  60. Song EK, Seon JK, Park SJ. How to avoid unintended increase of posterior slope in navigation-assisted open-wedge high tibial osteotomy. Orthopedics. 2007 Oct 1;30(10):S127.
  61. Pape D, Lorbach O, Schmitz C, Busch LC, Van Giffen N, Seil R, Kohn DM. Effect of a biplanar osteotomy on primary stability following high tibial osteotomy: a biomechanical cadaver study. Knee Surgery, Sports Traumatology, Arthroscopy. 2010 Feb 1;18(2):204-11.
  62. Krettek C, Miclau T, Gru O, Schandelmaier P, Tscherne H. Intraoperative control of axes, rotation and length in femoral and tibial fractures technical note. Injury. 1998 Dec 1;29:29-39.
  63. Saleh M, Harriman P, Edwards DJ. A radiological method for producing precise limb alignment. The Journal of bone and joint surgery. British volume. 1991 May;73(3):515-6.
  64. FuJISAwA YO, Masuhara KE, Shiomi SH. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. The Orthopedic clinics of North America. 1979 Jul;10(3):585.
  65. Miniaci A, Ballmer FT, Ballmer PM, Jakob RP. Proximal tibial osteotomy. A new fixation device. Clinical orthopaedics and related research. 1989 Sep(246):250-9.
  66. Noyes FR, Barber SD, Simon R. High tibial osteotomy and ligament reconstruction in varus angulated, anterior cruciate ligament-deficient knees: a two-to seven-year follow-up study. The American journal of sports medicine. 1993 Jan;21(1):2-12.
  67. Jakob RP, Murphy SB. Tibial osteotomy for varus gonarthrosis: indication, planning, and operative technique. Instructional course lectures. 1992;41:87.
  68. Spahn G, Kl inger HM, Harth P, Hofmann GO. Knorpelregeneration nach valgisierender Tibiakopfosteotomie. Ergebnisse einer arthroskopischen Studie. Zeitschrift für Orthopädie und Unfallchirurgie. 2012 Jun;150(03):272-9.
  69. Antonescu DN. Is knee osteotomy still indicated in knee osteoarthritis?. Acta Orthopaedica Belgica. 2000 Dec;66(5):421-32.
  70. Maas S, Diffo Kaze A, Dueck K, Pape D. Static and dynamic differences in fixation stability between a spacer plate and a small stature plate fixator used for high tibial osteotomies: a biomechanical bone composite study. International Scholarly Research Notices. 2013;2013.
  71. Kaze AD, Maas S, Waldmann D, Zilian A, Dueck K, Pape D. Biomechanical properties of five different currently used implants for open-wedge high tibial osteotomy. Journal of experimental orthopaedics. 2015 Dec 1;2(1):14.
  72. Takeuchi R, Ishikawa H, Kumagai K, Yamaguchi Y, Chiba N, Akamatsu Y, Saito T. Fractures around the lateral cortical hinge after a medial opening-wedge high tibial osteotomy: a new classification of lateral hinge fracture. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2012 Jan 1;28(1):85-94.
  73. Perren SM. Optimizing the degree of fixation stability based on the strain theory. Der Orthopade. 2010 Feb;39(2):132-8.
  74. Staubli AE, Jacob HA. Evolution of open-wedge high-tibial osteotomy: experience with a special angular stable device for internal fixation without interposition material. International orthopaedics. 2010 Feb 1;34(2):167-72.
  75. Gao L, Madry H, Chugaev DV, Denti M, Frolov A, Burtsev M, Magnitskaya N, Mukhanov V, Neyret P, Solomin LN, Sorokin E. Advances in modern osteotomies around the knee. Journal of experimental orthopaedics. 2019 Dec 1;6(1):9.
  76. Solomin LN, Shchepkina EA, Korchagin KL, Sabirov FK, Takata M, Tsuchiya H. The new method of long bone multilevel deformities correction using the orthopedic hexapod (preliminary report). Traumatology and Orthopedics of Russia. 2017 Oct 4;23(3):103-9.
  77. Mattei L, Lea S, Nicolaci G, Ferrero G, Marmotti A, Castoldi F. Closing wedge tibial osteotomy: is it an actual procedure nowadays?. planning. 2017;3:6.
  78. Bode G, Ogon P, Pestka J, Zwingmann J, Feucht M, Südkamp N, Niemeyer P. Clinical outcome and return to work following single-stage combined autologous chondrocyte implantation and high tibial osteotomy. International orthopaedics. 2015 Apr 1;39(4):689-96.
  79. Bode G, Schmal H, Pestka JM, Ogon P, Südkamp NP, Niemeyer P. A non-randomized controlled clinical trial on autologous chondrocyte implantation (ACI) in cartilage defects of the medial femoral condyle with or without high tibial osteotomy in patients with varus deformity of less than 5. Archives of orthopaedic and trauma surgery. 2013 Jan 1;133(1):43-9.
  80. Sterett WI, Steadman JR. Chondral resurfacing and high tibial osteotomy in the varus knee. The American journal of sports medicine. 2004 Jul;32(5):1243-9.
  81. Trinh TQ, Harris JD, Siston RA, Flanigan DC. Improved outcomes with combined autologous chondrocyte implantation and patellofemoral osteotomy versus isolated autologous chondrocyte implantation. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2013 Mar 1;29(3):566-74.
  82. Waller C, Hayes D, Block JE, London NJ. Unload it: the key to the treatment of knee osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy. 2011 Nov 1;19(11):1823-9.
  83. Parker DA, Beatty KT, Giuffre B, Scholes CJ, Coolican MR. Articular cartilage changes in patients with osteoarthritis after osteotomy. The American journal of sports medicine. 2011 May;39(5):1039-45.
  84. Verdonk PC, Verstraete KL, Almqvist KF, De Cuyper K, Veys EM, Verbruggen G, Verdonk R. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surgery, Sports Traumatology, Arthroscopy. 2006 Aug 1;14(8):694-706.
  85. Hernigou PH, Medevielle D, Debeyre J, Goutallier D. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. The Journal of bone and joint surgery. American volume. 1987 Mar;69(3):332.
  86. Jenny JY, Tavan A, Jenny G, Kehr P. Long-term survival rate of tibial osteotomies for valgus gonarthrosis. Revue de chirurgie orthopedique et reparatrice de l’appareil moteur. 1998 Jul;84(4):350-7.
  87. Wang G, Zheng G, Gruetzner PA, Mueller-Alsbach U, von Recum J, Staubli A, Nolte LP. A fluoroscopy-based surgical navigation system for high tibial osteotomy. Technology and Health Care. 2005 Jan 1;13(6):469-83.
  88. Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R, Saito T. Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Knee Surgery, Sports Traumatology, Arthroscopy. 2012 Mar 1;20(3):586-93.
  89. Picardo NE, Khan W, Johnstone D. Suppl 2: Computer[1]Assisted Navigation in High Tibial Osteotomy: A Systematic Review of the Literature. The Open Orthopaedics Journal. 2012;6:305.
  90. Victor J, Premanathan A. Virtual 3D planning and patient specific surgical guides for osteotomies around the knee: a feasibility and proof-of-concept study. The bone & joint journal. 2013 Nov;95(11_Supple_A):153-8.
  91. Jones GG, Jaere M, Clarke S, Cobb J. 3D printing and high tibial osteotomy. EFORT open reviews. 2018 May;3(5):254-9.
  92. Henckel J, Richards R, Lozhkin K, Harris S, Baena FR, Barrett AR, Cobb JP. Very low-dose computed tomography for planning and outcome measurement in knee replacement: the imperial knee protocol. The Journal of bone and joint surgery. British volume. 2006 Nov;88(11):1513-8.
  93. Woodacre T, Ricketts M, Evans JT, Pavlou G, Schranz P, Hockings M, Toms A. Complications associated with opening wedge high tibial osteotomy—A review of the literature and of 15 years of experience. The Knee. 2016 Mar 1;23(2):276-82.
  94. Valkering KP, van den Bekerom MP, Kappelhoff FM, Albers GR. Complications after tomofix medial opening wedge high tibial osteotomy. Journal of Knee Surgery. 2009 Jul 1;22(3):218.
  95. Amendola A, Bonasia DE. Results of high tibial osteotomy: review of the literature. International Orthopaedics 2010;34(2):155-60.
  96. Hui C, Salmon LJ, Kok A, Williams HA, Hockers N, van der Tempel WM, Chana R, Pinczewski LA. Long-term survival of high tibial osteotomy for medial compartment osteoarthritis of the knee. The American journal of sports medicine. 2011 Jan;39(1):64-70.
  97. Howells NR, Salmon L, Waller A, Scanelli J, Pinczewski LA. The outcome at ten years of lateral closing-wedge high tibial osteotomy: determinants of survival and functional outcome. The bone & joint journal. 2014 Nov;96(11):1491-7.
  98. Niinimäki TT, Eskelinen A, Mann BS, Junnila M, Ohtonen P, Leppilahti J. Survivorship of high tibial osteotomy in the treatment of osteoarthritis of the knee: Finnish registry-based study of 3195 knees. The Journal of bone and joint surgery. British volume. 2012 Nov;94(11):1517-21.
  99. Darden CN, Katsman A, Alaia MJ, Strauss EJ, Jazrawi LM. Short-Term Clinical Outcomes of High Tibial Osteotomy with the iBalance HTO System. Bulletin of the NYU Hospital for Joint Diseases. 2019 Oct 1;77(4):256-62.

How to Cite this article: Mhaskar VA, Jain Y, Maheshwari J. Current Concepts in High Tibial Osteotomy. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):24-31.

 (Abstract    Full Text HTML)   (Download PDF)


A Malunited Fibula with raised Lateral Malleolus treated Surgically by Fibular Osteotomy and Plating

Vol 3 | Issue 2 |  July-Dec 2018 | Page 54-55 | HR Jhunjhunwala.


Authors: HR Jhunjhunwala [1].

[1] Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India.

Address of Correspondence
Dr. HR Jhunjhunwala,
Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India.
Email: drhrj2@gmail.com


Abstract

Isolated fibular fractures are often considered innocuous and treated conservatively. They may malunited and predispose the ankle to severe twisting injuries. We present one such case where the patient presented with twisting injury to the ankle. Radiograph revealed a malunited fibula which was high riding. To prevent future such episodes, fibula was pulled down by doing an osteotomy and was stabilised with a plate. The union was uneventful and at final follow up pf two years the patient is symptom free
Keywords: malunited fibula, Osteotomy


References

1. Sakaki MH, Matsumura BAR, Dotta TDAG, et al. Epidemiologic study of ankle fractures in a tertiary hospital. Acta Orto Bras. 2014;22(2):90-93.
2. Thur CK, Edgren G, Jansson KÅ, et al. Epidemiology of adult ankle fractures in Sweden between 1987 and 2004: a population-based study of 91,410 Swedish inpatients. Acta Orthop. 2012;83(3):276-281.
3. McPhail SM, Dunstan J, Canning J, et al. Life impact of ankle fractures: Qualitative analysis of patient and clinician experiences. BMC Musculoskeletal Disorders. 2012;13:224.
4. Hosea TM, Carey CC, Harrer MF. The gender issue: Epidemiology of ankle injuries in athletes who participate in basketball. Clin Orthop Relat Res. 2000;(372):45-49.
5. Helfet DL, Haas NP, Schatzker J, et al. AO Philosophy and Principles of Fracture Management-Its Evolution and Evaluation. J Bone Joint Surg Am, 2003;85(6):1156-1160 .
6. Van Wensen RJA, van den Bekerom MPJ, Marti RK, et al. Reconstructive osteotomy of fibular malunion: review of the literature. Strategies in Trauma and Limb Reconstruction. 2011;6(2):51-57.
7. Zhenhua F, Waizy H, Ming X, et al. Lateral malleolus hook plate for comminuted Weber A and B fractures: A retrospective study. Indian J Orthop. 2013;47(4): 364–369.
8. Buscharino B, MorettiRG, Hungria JOS, et al. Biomechanical Study: Resistance Comparison of Posterior Antiglide Plate and Lateral Plate on Synthetic Bone Models Simulating Danis-Weber B Malleolar Fractures. Rev Bras Ortop. 2013;48(3):221-227.


How to Cite this article: Jhunjhunwala HR. A Malunited Fibula with raised Lateral Malleolus treated surgically by Fibular Osteotomy and Plating. Journal of Clinical Orthopaedics July-Dec 2018; 3(2):54-55.

(Abstract    Full Text HTML)      (Download PDF)