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Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy

PURPOSE: To compare navigation and weight bearing radiographic measurements of mechanical axis (MA) before and after closed wedge high tibial osteotomy (HTO) and to evaluate post-osteotomy changes in MA assessed during application of external varus or valgus force. MATERIALS AND METHODS: Data from 3...

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Autores principales: Bae, Dae Kyung, Lee, Jong Whan, Cho, Seong Jin, Song, Sang Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Knee Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596404/
https://www.ncbi.nlm.nih.gov/pubmed/28854769
http://dx.doi.org/10.5792/ksrr.16.026
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author Bae, Dae Kyung
Lee, Jong Whan
Cho, Seong Jin
Song, Sang Jun
author_facet Bae, Dae Kyung
Lee, Jong Whan
Cho, Seong Jin
Song, Sang Jun
author_sort Bae, Dae Kyung
collection PubMed
description PURPOSE: To compare navigation and weight bearing radiographic measurements of mechanical axis (MA) before and after closed wedge high tibial osteotomy (HTO) and to evaluate post-osteotomy changes in MA assessed during application of external varus or valgus force. MATERIALS AND METHODS: Data from 30 consecutive patients (30 knees) who underwent computer-assisted closed-wedge HTO were prospectively analyzed. Pre- and postoperative weight bearing radiographic evaluation of MA was performed. Under navigation guidance, pre- and post-osteotomy MA values were measured in an unloaded position. Any change in the post-osteotomy MA in response to external varus or valgus force, which was named as dynamic range, was evaluated with the navigation system. The navigation and weight bearing radiographic measurements were compared. RESULTS: Although there was a positive correlation between navigation and radiographic measurements, the reliability of navigation measurements of coronal alignment was reduced after osteotomy and wedge closing. The mean post-osteotomy MA value measured with the navigation was 3.5°±0.8° valgus in an unloaded position. It was 1.3°±0.8° valgus under varus force and 5.8°±1.1° valgus under valgus force. The average dynamic range was >±2°. CONCLUSIONS: Potential differences between the postoperative MAs assessed by weight bearing radiographs and the navigation system in unloaded position should be considered during computer-assisted closed wedge HTO. Care should be taken to keep the dynamic range within the permissible range of alignment goal in HTO.
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spelling pubmed-55964042017-09-13 Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy Bae, Dae Kyung Lee, Jong Whan Cho, Seong Jin Song, Sang Jun Knee Surg Relat Res Original Article PURPOSE: To compare navigation and weight bearing radiographic measurements of mechanical axis (MA) before and after closed wedge high tibial osteotomy (HTO) and to evaluate post-osteotomy changes in MA assessed during application of external varus or valgus force. MATERIALS AND METHODS: Data from 30 consecutive patients (30 knees) who underwent computer-assisted closed-wedge HTO were prospectively analyzed. Pre- and postoperative weight bearing radiographic evaluation of MA was performed. Under navigation guidance, pre- and post-osteotomy MA values were measured in an unloaded position. Any change in the post-osteotomy MA in response to external varus or valgus force, which was named as dynamic range, was evaluated with the navigation system. The navigation and weight bearing radiographic measurements were compared. RESULTS: Although there was a positive correlation between navigation and radiographic measurements, the reliability of navigation measurements of coronal alignment was reduced after osteotomy and wedge closing. The mean post-osteotomy MA value measured with the navigation was 3.5°±0.8° valgus in an unloaded position. It was 1.3°±0.8° valgus under varus force and 5.8°±1.1° valgus under valgus force. The average dynamic range was >±2°. CONCLUSIONS: Potential differences between the postoperative MAs assessed by weight bearing radiographs and the navigation system in unloaded position should be considered during computer-assisted closed wedge HTO. Care should be taken to keep the dynamic range within the permissible range of alignment goal in HTO. Korean Knee Society 2017-09 2017-09-01 /pmc/articles/PMC5596404/ /pubmed/28854769 http://dx.doi.org/10.5792/ksrr.16.026 Text en Copyright © 2017 Korean Knee Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Bae, Dae Kyung
Lee, Jong Whan
Cho, Seong Jin
Song, Sang Jun
Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy
title Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy
title_full Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy
title_fullStr Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy
title_full_unstemmed Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy
title_short Comparison of Mechanical Axis and Dynamic Range Assessed with Weight Bearing Radiographs and Navigation System in Closed Wedge High Tibial Osteotomy
title_sort comparison of mechanical axis and dynamic range assessed with weight bearing radiographs and navigation system in closed wedge high tibial osteotomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596404/
https://www.ncbi.nlm.nih.gov/pubmed/28854769
http://dx.doi.org/10.5792/ksrr.16.026
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