Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy

Purpose: To investigate the simultaneous effect of 3-dimensional (3D) hinge axis (HA) orientation on alignment parameters in all 3 anatomical planes in high tibial osteotomy. Methods: A computed tomography–based 3D model of a human tibia/fibula was used to establish a 3D tibial coordinate system bas...

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Main Authors: Quinten W.T. Veerman, M.Sc., Romy M. ten Heggeler, M.Sc., prof. Gabriëlle J.M. Tuijthof, M.Sc., Feike de Graaff, Ph.D., René Fluit, Ph.D., Roy A.G. Hoogeslag, M.D., Ph.D.
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Arthroscopy, Sports Medicine, and Rehabilitation
Online Access:http://www.sciencedirect.com/science/article/pii/S2666061X24000063
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author Quinten W.T. Veerman, M.Sc.
Romy M. ten Heggeler, M.Sc.
prof. Gabriëlle J.M. Tuijthof, M.Sc.
Feike de Graaff, Ph.D.
René Fluit, Ph.D.
Roy A.G. Hoogeslag, M.D., Ph.D.
author_facet Quinten W.T. Veerman, M.Sc.
Romy M. ten Heggeler, M.Sc.
prof. Gabriëlle J.M. Tuijthof, M.Sc.
Feike de Graaff, Ph.D.
René Fluit, Ph.D.
Roy A.G. Hoogeslag, M.D., Ph.D.
author_sort Quinten W.T. Veerman, M.Sc.
collection DOAJ
description Purpose: To investigate the simultaneous effect of 3-dimensional (3D) hinge axis (HA) orientation on alignment parameters in all 3 anatomical planes in high tibial osteotomy. Methods: A computed tomography–based 3D model of a human tibia/fibula was used to establish a 3D tibial coordinate system based on the tibial mechanical axis. In here, an HA was positioned and an opening-wedge high tibial osteotomy with a rotation angle of 10° over the HA was simulated. HA rotation in the axial plane ranged from 0° to 90° and HA tilt relative to the axial plane ranged from –20° to +20°. The study quantified the simultaneous effect of HA orientation on change of alignment parameters in all anatomical reference planes. Results: HA rotation within the tibial axial plane between orientations perpendicular to the coronal and sagittal planes primarily affected both coronal and sagittal plane alignment, with an inverse relationship between these planes (range: 0°-9.7°); the effect of HA rotation on the change in axial plane alignment was maximally 0.9°. In contrast, HA tilt relative to the tibial axial plane primarily affected axial alignment (maximum change: 6.9°); the effect on change in both coronal and sagittal plane alignment was maximally 0.6°. Conclusions: HA rotation in the tibial axial plane primarily affects sagittal and coronal plane alignment, and HA tilt relative to the tibial axial plane primarily affects axial plane alignment. Clinical Relevance: Integrating 3D HA orientation in malalignment planning and correction offers the potential to minimize unintended corrections in nontargeted planes in uniplanar correction osteotomies and to facilitate intentional multiplanar correction with a single osteotomy.
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spelling doaj.art-08ca56bc674a4274adbf55f33bc8241a2024-02-08T05:17:08ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2024-04-0162100888Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial OsteotomyQuinten W.T. Veerman, M.Sc.0Romy M. ten Heggeler, M.Sc.1prof. Gabriëlle J.M. Tuijthof, M.Sc.2Feike de Graaff, Ph.D.3René Fluit, Ph.D.4Roy A.G. Hoogeslag, M.D., Ph.D.5OCON Centre for Orthopaedic Surgery and Sports Medicine, Hengelo, the Netherlands; Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands; Address correspondence to Quinten Veerman, OCON Centre for Orthopaedic Surgery, P.O. Box 546, 7550 AM Hengelo, The Netherlands.OCON Centre for Orthopaedic Surgery and Sports Medicine, Hengelo, the Netherlands; Faculty of Engineering Technology, University of Twente, Enschede, the NetherlandsFaculty of Engineering Technology, University of Twente, Enschede, the NetherlandsOCON Centre for Orthopaedic Surgery and Sports Medicine, Hengelo, the NetherlandsFaculty of Science and Engineering, University of Groningen, Groningen, the NetherlandsOCON Centre for Orthopaedic Surgery and Sports Medicine, Hengelo, the NetherlandsPurpose: To investigate the simultaneous effect of 3-dimensional (3D) hinge axis (HA) orientation on alignment parameters in all 3 anatomical planes in high tibial osteotomy. Methods: A computed tomography–based 3D model of a human tibia/fibula was used to establish a 3D tibial coordinate system based on the tibial mechanical axis. In here, an HA was positioned and an opening-wedge high tibial osteotomy with a rotation angle of 10° over the HA was simulated. HA rotation in the axial plane ranged from 0° to 90° and HA tilt relative to the axial plane ranged from –20° to +20°. The study quantified the simultaneous effect of HA orientation on change of alignment parameters in all anatomical reference planes. Results: HA rotation within the tibial axial plane between orientations perpendicular to the coronal and sagittal planes primarily affected both coronal and sagittal plane alignment, with an inverse relationship between these planes (range: 0°-9.7°); the effect of HA rotation on the change in axial plane alignment was maximally 0.9°. In contrast, HA tilt relative to the tibial axial plane primarily affected axial alignment (maximum change: 6.9°); the effect on change in both coronal and sagittal plane alignment was maximally 0.6°. Conclusions: HA rotation in the tibial axial plane primarily affects sagittal and coronal plane alignment, and HA tilt relative to the tibial axial plane primarily affects axial plane alignment. Clinical Relevance: Integrating 3D HA orientation in malalignment planning and correction offers the potential to minimize unintended corrections in nontargeted planes in uniplanar correction osteotomies and to facilitate intentional multiplanar correction with a single osteotomy.http://www.sciencedirect.com/science/article/pii/S2666061X24000063
spellingShingle Quinten W.T. Veerman, M.Sc.
Romy M. ten Heggeler, M.Sc.
prof. Gabriëlle J.M. Tuijthof, M.Sc.
Feike de Graaff, Ph.D.
René Fluit, Ph.D.
Roy A.G. Hoogeslag, M.D., Ph.D.
Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy
Arthroscopy, Sports Medicine, and Rehabilitation
title Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy
title_full Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy
title_fullStr Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy
title_full_unstemmed Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy
title_short Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy
title_sort three dimensional hinge axis orientation contributes to simultaneous alignment correction in all three anatomical planes in opening wedge high tibial osteotomy
url http://www.sciencedirect.com/science/article/pii/S2666061X24000063
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