{"title":"Biplanar Lateral Hemi-Wedge Osteotomy for the Correction of Severe Tibial Varus Deformity.","authors":"Wolf Petersen, Hassan Al Mustafa, Martin Häner","doi":"10.1016/j.eats.2024.103211","DOIUrl":null,"url":null,"abstract":"<p><p>Indication for this hemi-wedge high tibial osteotomy is the combination of medial osteoarthritis or cartilage damage, varus deformity of >10°, and medial proximal tibial angle of <80°. The proximal lateral tibia is exposed via a skin incision of approximately 10 cm length between the tibial tuberosity and the head of the fibula. After detachment of the anterior tibial muscle, a first oblique guidewire marks the main osteotomy plane and a second guidewire marks the hemi-wedge. Then, the osteotomy is performed along the guidewires with an oscillating saw and the laterally based wedge is removed. After percutaneous needling of the medial collateral ligament with a cannula, the lateral gap is closed and stabilized with an angular-stable plate. The rehabilitation protocol includes partial weight-bearing with 10 kg for 6 weeks and free range of motion.</p>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"13 12","pages":"103211"},"PeriodicalIF":1.2000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704884/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Techniques","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.eats.2024.103211","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
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Abstract
Indication for this hemi-wedge high tibial osteotomy is the combination of medial osteoarthritis or cartilage damage, varus deformity of >10°, and medial proximal tibial angle of <80°. The proximal lateral tibia is exposed via a skin incision of approximately 10 cm length between the tibial tuberosity and the head of the fibula. After detachment of the anterior tibial muscle, a first oblique guidewire marks the main osteotomy plane and a second guidewire marks the hemi-wedge. Then, the osteotomy is performed along the guidewires with an oscillating saw and the laterally based wedge is removed. After percutaneous needling of the medial collateral ligament with a cannula, the lateral gap is closed and stabilized with an angular-stable plate. The rehabilitation protocol includes partial weight-bearing with 10 kg for 6 weeks and free range of motion.
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