Müller S, Frosch KH, Frings J, Berninger M, Krause M. Biplanar high tibial osteotomy for the combined correction of varus and posterior tibial slope malalignment.
Orthop Traumatol Surg Res 2022;
109:103339. [PMID:
35643363 DOI:
10.1016/j.otsr.2022.103339]
[Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/16/2022] [Accepted: 03/29/2022] [Indexed: 02/03/2023]
Abstract
Varus malalignment combined with an increased posterior tibial slope (PTS) in the ACL deficient knee is a frequent pathology; yet, treatment for this condition remains challenging. The presented biplanar osteotomy technique allows to simultaneously address both components of malalignment in a single step. A detailed preoperative planning is best achieved by means of a digital planning software and constant intraoperative imaging is performed to verify the correction angle. A bony wedge is resected along with the extension osteotomy according to the preoperative planning and the medial-opening tibial osteotomy site is filled with bone allograft. Two bicortical lag screws are placed in anterior-posterior direction to secure the extension osteotomy, whereas a plate fixation is used for the medial-open osteotomy.
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