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The Effect of Wedge and Tibial Slope Angles on Knee Contact Pressure and Kinematics Following Medial Opening-Wedge High Tibial Osteotomy Black, Marianne Susan; d’Entremont, Agnes Germaine; McCormack, Robert G.; Hansen, Gregory; Carr, Derek; Wilson, David R.

Abstract

Background: High tibial osteotomy is a surgical procedure to treat medial compartment osteoarthritis in varus knees. The reported success rates of the procedure are inconsistent, which may be due to sagittal plane alignment of the osteotomy. The objective of this study was to determine the effect of changing tibial slope, for a range of tibial wedge angles in high tibial osteotomy, on knee joint contact pressure location and kinematics during continuous loaded flexion/extension. Methods: Seven cadaveric knee specimens were cycled through flexion and extension in an Oxford knee-loading rig. The osteotomy on each specimen was adjusted to seven clinically relevant wedge and slope combinations. We used pressure sensors to determine the position of the centre of pressure in each compartment of the tibial plateau and infrared motion capture markers to determine tibiofemoral and patellofemoral kinematics. Findings: In early knee flexion, a 5 degree increase in tibial slope shifted the centre of pressure in the medial compartment anteriorly by 7mm for a 15 degree wedge (p<0.001), (from the neutral slope/wedge position). At all wedge angles, increasing the tibial slope resulted in the tibia translating anteriorly (p<0.001). Interpretation: Changes to the tibial slope during high tibial osteotomy for all tested wedge angles shifted the centre of pressure in both the medial and lateral compartments substantially and altered knee kinematics. Tibial slope should be controlled during high tibial osteotomy to prevent unwanted changes in tibial plateau contact loads.

Item Metadata

Title
The Effect of Wedge and Tibial Slope Angles on Knee Contact Pressure and Kinematics Following Medial Opening-Wedge High Tibial Osteotomy
Creator
Black, Marianne Susan; d’Entremont, Agnes Germaine; McCormack, Robert G.; Hansen, Gregory; Carr, Derek; Wilson, David R.
Contributor
Centre for Hip Health and Mobility
Date Issued
2018-01
Description
Background: High tibial osteotomy is a surgical procedure to treat medial compartment osteoarthritis in varus knees. The reported success rates of the procedure are inconsistent, which may be due to sagittal plane alignment of the osteotomy. The objective of this study was to determine the effect of changing tibial slope, for a range of tibial wedge angles in high tibial osteotomy, on knee joint contact pressure location and kinematics during continuous loaded flexion/extension. Methods: Seven cadaveric knee specimens were cycled through flexion and extension in an Oxford knee-loading rig. The osteotomy on each specimen was adjusted to seven clinically relevant wedge and slope combinations. We used pressure sensors to determine the position of the centre of pressure in each compartment of the tibial plateau and infrared motion capture markers to determine tibiofemoral and patellofemoral kinematics. Findings: In early knee flexion, a 5 degree increase in tibial slope shifted the centre of pressure in the medial compartment anteriorly by 7mm for a 15 degree wedge (p<0.001), (from the neutral slope/wedge position). At all wedge angles, increasing the tibial slope resulted in the tibia translating anteriorly (p<0.001). Interpretation: Changes to the tibial slope during high tibial osteotomy for all tested wedge angles shifted the centre of pressure in both the medial and lateral compartments substantially and altered knee kinematics. Tibial slope should be controlled during high tibial osteotomy to prevent unwanted changes in tibial plateau contact loads.
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2019-01-01
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NoDerivatives 4.0 International
DOI
10.14288/1.0372507
URI
http://hdl.handle.net/2429/67309
Affiliation
Applied Science, Faculty of; Medicine, Faculty of; Non UBC; Mechanical Engineering, Department of; Orthopaedic Surgery, Department of
Citation
Black MS, d'Entremont AG, McCormack RG, Hansen G, Carr D, Wilson DR. The effect of wedge and tibial slope angles on knee contact pressure and kinematics following medial opening-wedge high tibial osteotomy. Clin Biomech (Bristol, Avon). 2018 Jan;51:17-25.
Peer Review Status
Reviewed
Scholarly Level
Faculty; Graduate
Rights URI
http://creativecommons.org/licenses/by-nd/4.0/
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Attribution-NoDerivatives 4.0 International