Sawing toward the fibular head during open-wedge high tibial osteotomy carries the risk of popliteal artery injury.
Purpose: Popliteal artery injury is a rare but devastating complication of open-wedge high tibial osteotomy (OWHTO). The objectives of this study were: to document the location of the artery in the virtual osteotomy plane (VOP), to measure the minimal distance between the popliteal artery and three...
| Published in: | Knee Surgery, Sports Traumatology, Arthroscopy Vol. 28; no. 5; pp. 1365 - 1372 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
May2020
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142848599&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142848599 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09422056 NRT jtl: Knee Surgery, Sports Traumatology, Arthroscopy issn: 09422056 maglogo: N pubinfo: dt: May2020 vid: 28 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 142848599 142848599 NLM30809721 142848599 10.1007/s00167-019-05439-w NLM30809721 142848599 ppf: 1365 ppct: 7 formats: tig: atl: Sawing toward the fibular head during open-wedge high tibial osteotomy carries the risk of popliteal artery injury. aug: au: Kang, Taehoon Lee, Do Weon Park, Jae Young Han, Hyuk-Soo Lee, Myung Chul Ro, Du Hyun affil: Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, South Korea sug: subj: Popliteal Artery Injuries Osteotomy Adverse Effects Tibia Surgery Osteotomy Methods Aged, 80 and Over Osteoarthritis, Knee Surgery Popliteal Artery Tibia Popliteal Artery Anatomy and Histology Male Aged Female Adult Fibula Risk Factors Middle Age Imaging, Three-Dimensional Postoperative Complications Funding Source Human Aged, 80 & over Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Purpose: Popliteal artery injury is a rare but devastating complication of open-wedge high tibial osteotomy (OWHTO). The objectives of this study were: to document the location of the artery in the virtual osteotomy plane (VOP), to measure the minimal distance between the popliteal artery and three virtual saw-progression lines (VSLs), and to present a safe sawing technique for OWHTO.Method: In total, 45 computed tomography angiographies were reconstructed and virtual osteotomy was simulated using 3D image-processing software. The VOP was defined as an inclined plane commencing 3.5 cm below the articular plane towards the fibular head. VSLs were defined as saw-progression guidelines that lie on the VOP: "VSL-mid" runs from the midpoint of the tibial medial cortex towards the fibular head; "VSL-ant" starts from the same point as VSL-mid, but runs 10° anterior to the fibular head; and "VSL-post" runs 10° posterior to the fibular head. The distances between the popliteal artery and the three VSLs were measured, and the risk of injury was assessed.Results: The popliteal artery was located 20.7° posterior to VSL-mid and 51 mm from the starting point. The minimum distance between the popliteal artery and VSL-mid was 18 mm (99% confidence interval 9-27 mm). When the saw was moved along VSL-mid, 42% of the arteries were susceptible to injury. However, when it followed VSL-ant, there was no risk of injury.Conclusions: Sawing toward the fibular head carries a risk of popliteal artery injury and should not be performed. When sawing in OWHTO, the recommended target should be 10° anterior to the fibular head. This technique eliminates the risk of popliteal artery injury. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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