Factors influencing the posterior tibial slope after medial opening-wedge high tibial osteotomy.

IF 4.3 3区工程技术 Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Frontiers in Bioengineering and Biotechnology Pub Date : 2025-03-21 eCollection Date: 2025-01-01 DOI:10.3389/fbioe.2025.1525542

Junwei Li, Qingqing Yang, Min Zhang, Jie Yao, Bolun Liu, Yichao Luan, Yunlin Chen, Chaohua Fang, Cheng-Kung Cheng

{"title":"Factors influencing the posterior tibial slope after medial opening-wedge high tibial osteotomy.","authors":"Junwei Li, Qingqing Yang, Min Zhang, Jie Yao, Bolun Liu, Yichao Luan, Yunlin Chen, Chaohua Fang, Cheng-Kung Cheng","doi":"10.3389/fbioe.2025.1525542","DOIUrl":null,"url":null,"abstract":"Introduction: Medial Opening-wedge High Tibial Osteotomy (HTO) is an effective treatment for medial compartment osteoarthritis and knee varus in relatively young and active patients. While it can effectively correct lower limb alignment in the coronal plane, it may also affect the posterior tibial slope (PTS) in the sagittal plane. However, the factors influencing PTS and methods for maintaining PTS stability remain controversial.Methods: A lower limb geometric model was constructed based on the CT data from a patient with medial knee osteoarthritis and varus knee. Multiple models were developed to simulate various conditions: seven different medial cortex inclinations of the proximal tibia (-15°-15°), seven coronal plane inclinations of the central osteotomy plane (-15°-15°), seven sagittal plane inclinations of the hinge axis (-15°-15°), seven hinge axis heights (-7 mm-7 mm), and seven hinge axis inclinations in the axial plane (-15°-15°). Changes in the ratio between anterior and posterior opening gap (RAPOG) and PTS were analyzed.Results: The medial cortex inclination of the proximal tibia, coronal plane inclination of the central osteotomy plane, inclination of the sagittal plane of the hinge axis, and height of the hinge axis did not alter the PTS; however, these factors did affect RAPOG, with increased values leading to decrease in RAPOG. The ranges of RAPOG for these factors were 76.37%-54.83%, 68.91%-60.94%, 68.04%-64.08%, and 70.38%-62.61%, respectively. However, the hinge axis inclination on the axial plane affects PTS, for inclinations of -15°, -10°, -5°, 0°, 5°, 10°, and 15°, the PTS decreased 2.48°, 1.83°, 0.98°, 0°, -0.97°, -1.82°, and -2.53°, respectively. To maintain a constant PTS, RAPOG should be readjusted to 65.13%, 66.01%, 66.27%, 65.76%, 65.03%, 65.15%, and 65.57%, respectively.Discussion: The inclination of the hinge axis in the axial plane affects PTS, as its value increases, PTS also increases. To maintain a constant PTS, RAPOG should be readjusted. Understanding these relationships is essential for optimizing surgical techniques to minimize unintended changes in PTS.","PeriodicalId":12444,"journal":{"name":"Frontiers in Bioengineering and Biotechnology","volume":"13 ","pages":"1525542"},"PeriodicalIF":4.3000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968708/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Bioengineering and Biotechnology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.3389/fbioe.2025.1525542","RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Medial Opening-wedge High Tibial Osteotomy (HTO) is an effective treatment for medial compartment osteoarthritis and knee varus in relatively young and active patients. While it can effectively correct lower limb alignment in the coronal plane, it may also affect the posterior tibial slope (PTS) in the sagittal plane. However, the factors influencing PTS and methods for maintaining PTS stability remain controversial.

Methods: A lower limb geometric model was constructed based on the CT data from a patient with medial knee osteoarthritis and varus knee. Multiple models were developed to simulate various conditions: seven different medial cortex inclinations of the proximal tibia (-15°-15°), seven coronal plane inclinations of the central osteotomy plane (-15°-15°), seven sagittal plane inclinations of the hinge axis (-15°-15°), seven hinge axis heights (-7 mm-7 mm), and seven hinge axis inclinations in the axial plane (-15°-15°). Changes in the ratio between anterior and posterior opening gap (RAPOG) and PTS were analyzed.

Results: The medial cortex inclination of the proximal tibia, coronal plane inclination of the central osteotomy plane, inclination of the sagittal plane of the hinge axis, and height of the hinge axis did not alter the PTS; however, these factors did affect RAPOG, with increased values leading to decrease in RAPOG. The ranges of RAPOG for these factors were 76.37%-54.83%, 68.91%-60.94%, 68.04%-64.08%, and 70.38%-62.61%, respectively. However, the hinge axis inclination on the axial plane affects PTS, for inclinations of -15°, -10°, -5°, 0°, 5°, 10°, and 15°, the PTS decreased 2.48°, 1.83°, 0.98°, 0°, -0.97°, -1.82°, and -2.53°, respectively. To maintain a constant PTS, RAPOG should be readjusted to 65.13%, 66.01%, 66.27%, 65.76%, 65.03%, 65.15%, and 65.57%, respectively.

Discussion: The inclination of the hinge axis in the axial plane affects PTS, as its value increases, PTS also increases. To maintain a constant PTS, RAPOG should be readjusted. Understanding these relationships is essential for optimizing surgical techniques to minimize unintended changes in PTS.

查看原文本刊更多论文

胫骨内侧楔形高位截骨后胫骨后斜度的影响因素。

简介：内侧开楔式胫骨高位截骨术（HTO）是治疗相对年轻和活跃的患者内侧骨室骨关节炎和膝关节内翻的有效方法。虽然能有效矫正冠状面下肢对线，但也可能影响矢状面胫骨后坡（PTS）。然而，影响PTS的因素和维持PTS稳定性的方法仍然存在争议。方法：对1例膝关节内侧骨关节炎和膝内翻患者的CT资料进行下肢几何模型的建立。建立了多个模型来模拟各种情况：胫骨近端7种不同的内侧皮质倾角（-15°-15°），中央截骨平面7种冠状面倾角（-15°-15°），7种铰链轴矢状面倾角（-15°-15°），7种铰链轴高度（-7 mm-7 mm）， 7种轴向面铰链轴倾角（-15°-15°）。分析前后开孔间隙比值（RAPOG）和PTS的变化。结果：胫骨近端内侧皮质倾角、中央截骨平面冠状面倾角、铰链轴矢状面倾角、铰链轴高度对PTS无明显影响；然而，这些因素确实会影响RAPOG，值的增加导致RAPOG的下降。这些因素的RAPOG范围分别为76.37% ~ 54.83%、68.91% ~ 60.94%、68.04% ~ 64.08%和70.38% ~ 62.61%。而轴向平面上的铰链轴倾角影响PTS，当轴倾角为-15°、-10°、-5°、0°、5°、10°和15°时，PTS分别降低2.48°、1.83°、0.98°、0°、-0.97°、-1.82°和-2.53°。为保持PTS不变，应将RAPOG分别调整为65.13%、66.01%、66.27%、65.76%、65.03%、65.15%和65.57%。讨论：铰轴在轴向面的倾角影响PTS，随着其值的增大，PTS也随之增大。为了保持恒定的PTS，应重新调整RAPOG。了解这些关系对于优化手术技术以减少PTS的意外变化至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Frontiers in Bioengineering and Biotechnology Chemical Engineering-Bioengineering

CiteScore

8.30

自引率

5.30%

发文量

2270

审稿时长

12 weeks

期刊介绍： The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs. In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.