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Increased contact area of flange and decreased wedge volume of osteotomy site by open wedge distal tibial tuberosity arc osteotomy compared to the conventional technique

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate the area of the osteotomy surface, including the flange and wedge volume, in open wedge high tibial osteotomy (OWHTO), distal tibial tuberosity osteotomy (DTO), and distal tibial tuberosity arc osteotomy (DTAO) using tibial sawbones. It was hypothesized that the area of the osteotomy surface, including the flange, in DTAO was larger than that in OWHTO and DTO and that the wedge volume in DTAO was smaller than that in OWHTO and DTO.

Methods

Fifteen tibial sawbones were divided equally into three groups: OWHTO, DTO, and DTAO. The total area of the osteotomy surface in OWHTO, DTO, and DTAO was compared using image analysis software. The contact area of the flange and the wedge volume at wedge heights of 5, 10, and 15 mm were compared among osteotomy types. One-way repeated-measures analysis of variance was used to compare the total area of the osteotomy surface, the contact area of the flange, and the wedge volume at 5, 10, and 15 mm in OWHTO, DTO, and DTAO.

Results

The total area of the osteotomy surface in DTO and DTAO was significantly larger than that in OWHTO (P < 0.05). The contact area of the flange in DTAO was significantly larger than that in OWHTO at each wedge height (P < 0.05). In addition, the contact area of the flange in DTAO was significantly larger than that in DTO at wedge heights of 5 and 15 mm (P < 0.05). The wedge volume in DTAO was significantly smaller than that in DTO at each wedge height (P < 0.05).

Conclusions

This study demonstrated that an increase in the flange contact area and a decrease in the wedge volume in the opening gap were found in DTAO compared to DTO. This would be an advantage for anteroposterior screw insertion from the flange to the distal tibial fragment and bone union at the osteotomy site.

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Abbreviations

OWHTO:

Open wedge high tibial osteotomy

OA:

Osteoarthritis

DTO:

Distal tibial tuberosity osteotomy

DTAO:

Distal tibial tuberosity arc osteotomy

ANOVA:

Analysis of variance

ICCs:

Intraclass correlation coefficients

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Funding

No funding was obtained for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Shuntaro Nejima, Ken Kumagai, Hiroshi Fujimaki, Shunsuke Yamada, Masaichi Sotozawa, Joji Matsubara & Yutaka Inaba

Authors
  1. Shuntaro Nejima
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  2. Ken Kumagai
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  3. Hiroshi Fujimaki
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  4. Shunsuke Yamada
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  5. Masaichi Sotozawa
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  6. Joji Matsubara
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  7. Yutaka Inaba
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Contributions

SN: study design, data collection, interpreting the data, and writing the paper. MS: data collection. KK, HF, SY, JM, and YI: interpretation. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ken Kumagai.

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Nejima, S., Kumagai, K., Fujimaki, H. et al. Increased contact area of flange and decreased wedge volume of osteotomy site by open wedge distal tibial tuberosity arc osteotomy compared to the conventional technique. Knee Surg Sports Traumatol Arthrosc 29, 3450–3457 (2021). https://doi.org/10.1007/s00167-020-06296-8

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  • DOI: https://doi.org/10.1007/s00167-020-06296-8

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