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Journal articles on the topic 'Opening-wedge'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Oh, Seung Min, Kyung Wook Nha, and Jae Hwi Han. "Opening Wedge High Tibia Osteotomy." Journal of the Korean Orthopaedic Association 53, no. 4 (2018): 293. http://dx.doi.org/10.4055/jkoa.2018.53.4.293.

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2

Puddu, Giancarlo, and Vittorio Franco. "Femoral antivalgus opening wedge osteotomy." Operative Techniques in Sports Medicine 8, no. 1 (January 2000): 56–60. http://dx.doi.org/10.1016/s1060-1872(00)80026-x.

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3

Noyes, Frank R., William Mayfield, Sue D. Barber-Westin, Jay C. Albright, and Timothy P. Heckmann. "Opening Wedge High Tibial Osteotomy." American Journal of Sports Medicine 34, no. 8 (August 2006): 1262–73. http://dx.doi.org/10.1177/0363546505286144.

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4

O'Malley, Michael, Patrick J. Reardon, Ayoosh Pareek, Aaron Krych, and Michael J. Stuart. "Opening-Wedge Proximal Tibial Osteotomy." Arthroscopy Techniques 5, no. 4 (August 2016): e769-e774. http://dx.doi.org/10.1016/j.eats.2016.03.005.

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5

Zehir, Sinan, Murat Çalbıyık, Ercan Şahin, Mahmut Kalem, Murat Songür, and Deniz İpek. "Opening Wedge High Tibial Osteotomy Using Tricalcium Phosphate Wedge." Orthopaedic Journal of Sports Medicine 2, no. 11_suppl3 (November 1, 2014): 2325967114S0013. http://dx.doi.org/10.1177/2325967114s00137.

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Objectives: High tibial osteotomy is a standard procedure indicated for early medial sided osteoarthritis in varus knees. In this study, we present the early results of high tibial open wedge osteotomy cases using beta-tricalcium phosphate as a graft substitute and Otis-c plate. Methods: Between years 2010 and 2013, 47 cases of (34F, 13 M) medial compartmental gonarthrosis with genu varum deformity treated with high tibial osteotomy, were evaluated with at least one year follow-up, preoperatively both clinically and radiologically. Clinical evaluation involved functional assessment and pain evaluation using Lysholm and visual analog scale (VAS) scores, including knee range-of-motion. Radiological evaluation included medial joint space measurements on weight bearing knee radiographs with measurements of varus angle and posterior tibial slope. Surgical procedure included standard arthroscopy followed by medial sided opening wedge osteotomy with correction of the varus deformity using β- tricalcium phosphate graft substitute and fixation of the osteotomy site using Otis-C plate and locking screws. All patients were evaluated at the end of minimum one-year follow-up period. Results: Mean age of the patients was 56,7 (50- 65) years and mean follow-up period was 24,5 (12- 44) months. Mean duration of surgery was 47,4±10.2 minutes. No case of nonunion, delayed union, neurovascular injury or iatrogenic fracture was encountered. Two cases developed deep vein thrombosis and one case developed superficial wound infection managed successfully by local debridement with retention of implants and antibiotics. Mean duration of union was 13,4±2.7 weeks. Mean preoperative and follow-up range-of-motion were measured as 131±8.9 and 129±9.1 respectively with no statistical difference. Preoperative and follow-up VAS scores showed significant difference as 7.6±1.76 and 2.3±1.08 respectively (p=0.001). Also Lysholm scores improved significantly at the end of the follow-up period (43.23±4.01 vs. 76.3±3.7 p<0,001). Radiological evaluation revealed mean correction angle of 10.84±2.70 degrees at follow-up. Mean posterior tibial slope was measured relatively unchanged (8.6±1.70° degrees preoperatively versus 8.2±2.30° follow-up). Medial joint space width measurements showed a significant increase (pre-op 3.7±1.6 mm. versus 4.6±1.32 mm. at the follow-up (p<0.001)). Conclusion: Medial opening wedge osteotomy for treatment of early medial compartment gonarthrosis in varus knees is still a valuable option. Our short term preliminary results using beta-tricalcium phosphate wedge graft substitute and Otis-c plate-screw osteosynthesis revealed satisfactory short term clinical and radiological results with acceptable complication rates.

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6

Koshino, Tomihisa. "Opening Wedge High Tibial Osteotomy Using a Bioceramic Wedge." Techniques in Knee Surgery 3, no. 4 (December 2004): 206–14. http://dx.doi.org/10.1097/00132588-200412000-00002.

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7

Cho, Se Hyun, Sun Chul Hwang, Kang Min Sohn, and Hyung Kan Kim. "Comparison of Closing-Wedge and Opening-Wedge High Tibial Osteotomies." Journal of the Korean Orthopaedic Association 47, no. 2 (2012): 104. http://dx.doi.org/10.4055/jkoa.2012.47.2.104.

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8

Esenkaya, Irfan. "Opening Wedge Proximal Tibial Osteotomy Using the Plate With Wedge." Techniques in Knee Surgery 5, no. 4 (December 2006): 261–73. http://dx.doi.org/10.1097/01.btk.0000234080.71269.b6.

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9

Sarabia-Condes, J. M., S. Villaescusa-Marín, C. Hernández-García, and M. A. Martín-Ferrero. "Opening-wedge High Tibial Osteotomy with a Tricalcium Phosphate Wedge." Revista Española de Cirugía Ortopédica y Traumatología (English Edition) 51, no. 4 (July 2007): 182–87. http://dx.doi.org/10.1016/s1988-8856(07)70032-9.

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10

Al-Saati, Maʼad F., Robert A. Magnussen, Guillaume Demey, Sebastien Lustig, Elvire Servien, and Philippe Neyret. "Lateral Opening-wedge High Tibial Osteotomy." Techniques in Knee Surgery 10, no. 3 (September 2011): 178–85. http://dx.doi.org/10.1097/btk.0b013e31822bac0f.

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11

Ferrao, Paulo N., and Nikiforos P. Saragas. "Rotational and Opening Wedge Basal Osteotomies." Foot and Ankle Clinics 19, no. 2 (June 2014): 203–21. http://dx.doi.org/10.1016/j.fcl.2014.02.004.

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12

Tjoumakaris, Fotios P., Nick J. Lombardi, Bradford S. Tucker, and Matthew D. Pepe. "Medial Opening Wedge High Tibial Osteotomy." Orthopaedic Journal of Sports Medicine 3, no. 7_suppl2 (July 2015): 2325967115S0012. http://dx.doi.org/10.1177/2325967115s00124.

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13

Chahla, Jorge, Chase S. Dean, Justin J. Mitchell, Gilbert Moatshe, Raphael Serra Cruz, and Robert F. LaPrade. "Medial Opening Wedge Proximal Tibial Osteotomy." Arthroscopy Techniques 5, no. 4 (August 2016): e919-e928. http://dx.doi.org/10.1016/j.eats.2016.04.019.

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14

Javidan, Pooya, Gregory J. Adamson, Jennifer R. Miller, Pierre Durand, Patrick A. Dawson, Marilyn M. Pink, and Thay Q. Lee. "The Effect of Medial Opening Wedge Proximal Tibial Osteotomy on Patellofemoral Contact." American Journal of Sports Medicine 41, no. 1 (October 29, 2012): 80–86. http://dx.doi.org/10.1177/0363546512462810.

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Background: It has been suggested that patellofemoral contact pressures and contact forces may be altered secondary to an opening wedge high tibial osteotomy, yet few data are available that quantify the effect of varying degrees of medial opening wedge osteotomy on the patellofemoral joint contact characteristics. Hypothesis: Opening wedge medial proximal tibial osteotomy will increase patellofemoral contact force and pressure. Study Design: Controlled laboratory study. Methods: Nine human cadaver knees were used. Pressure-sensitive film was placed in the suprapatellar pouch, leaving the patellar tendon and medial and lateral retinacula intact. The quadriceps tendon was attached to a materials testing machine along the axis of the femur, whereby a pulley mechanism generated 950 N of force. Patellofemoral contact characteristics were measured with pressure-sensitive film at 30°, 60°, 90°, and 120° of flexion for the native knee and after subsequent 10-mm and 15-mm medial opening wedge proximal tibial osteotomies. The film was analyzed with imaging software. Results: There was a statistically significant increase ( P < .05) in mean contact pressure at 30° and 120° between the 10-mm osteotomy and native knee and across all flexion angles between the 15-mm osteotomy and native knee. Furthermore, a significant difference was seen in peak pressures when native knees were compared with 10-mm and 15-mm opening wedge osteotomies at all flexion angles. Conclusion: There was a significant increase in patellofemoral pressures at varying degrees of knee flexion after medial opening wedge proximal tibial osteotomies of only 10 mm; a larger osteotomy resulted in a greater increase. Clinical Relevance: When performing a medial opening wedge proximal tibial osteotomy, the surgeon should consider the negative effects of increased patellofemoral peak pressure.

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15

Kraus, Jonathan, Michael J. Ziegele, Mei Wang, and Brian Law. "First Tarsometatarsal Joint Loading After Sequential Correction of Hallux Valgus Using a Proximal Opening Wedge Metatarsal Osteotomy and Distal Soft Tissue Procedure." Foot & Ankle Orthopaedics 6, no. 3 (July 1, 2021): 247301142110269. http://dx.doi.org/10.1177/24730114211026934.

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Background: The proximal opening wedge osteotomy (POWO) of the first metatarsal (TMT-1) is commonly performed in the operative treatment of hallux valgus. Limited work has been dedicated to study POWO’s effect on the TMT-1 joint, however. The purpose of this study is to evaluate the changes in TMT-1 joint contact stress following POWO of the first metatarsal. Methods: Five fresh-frozen cadaveric below-knee specimens (mean age: 73 years) with hallux valgus deformities (mean hallux valgus angle [HVA]: 37.4 ± 8.5 degrees) were studied. The specimens were loaded to 400 N on an MTS servohydraulic load frame. Joint contact characteristics at TMT-1 joint were measured with a Tekscan pressure sensor (Model 6900, 1100 psi; Tekscan Inc, Boston, MA) with various opening wedge sizes of 3, 5, and 7 mm both without and with a distal soft tissue release (DSTR). The contact force, area, and peak contact stress were compared among groups using analysis of variance and post hoc multiple comparisons over the untreated (Dunnett test, P < .05). Results: The mean contact force was 47.7 ± 33.5 N for untreated specimens. This increased sequentially with opening wedge size and reached statistical significance for 7-mm opening wedge (129.7 ± 62.3 N, P = .01) and 7-mm wedge + DSTR (134.8 ± 60.5 N, P = .008). The mean peak contact stress was 2.8 ± 1.3 MPa for the untreated specimens and increased incrementally with wedge size to 5.7 ± 3.0 MPa for 7-mm wedge only ( P = .03) and 5.6 ± 2.5 MPa for 7-mm wedge + DSTR ( P = .05). The contact area increased with corrections, but none reached significance. Conclusion: With increasing opening wedge size, loading of the TMT-1 joint increases. Joint stresses higher than 4.7 MPa have been shown to be chondrotoxic, potentially predisposing patients to arthritic joint changes following POWO. Level of Evidence: XXXXXX

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16

Duivenvoorden, T., R. Brouwer, K. Bos, M. Reijman, S. Bierma - Zeinstra, and J. Verhaar. "Better survival of valgus opening-wedge high tibial osteotomy: 10-year results of a RCT comparing closing wedge and opening wedge technique." Osteoarthritis and Cartilage 22 (April 2014): S468. http://dx.doi.org/10.1016/j.joca.2014.02.890.

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17

Noyes, Frank R., Steven X. Goebel, and John West. "Opening Wedge Tibial Osteotomy: The 3-Triangle Method to Correct Axial Alignment and Tibial Slope." American Journal of Sports Medicine 33, no. 3 (March 2005): 378–87. http://dx.doi.org/10.1177/0363546504269034.

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Background Although a change in tibial slope may occur during a medial opening wedge osteotomy, calculations have not been defined to address this problem. The authors investigated geometric factors important to correct axial alignment and tibial slope during osteotomy. Purpose To calculate, through 3-dimensional analysis of the proximal tibia, how the angle of the opening wedge along the anteromedial tibial cortex influences the tibial slope (sagittal plane) and valgus correction (coronal plane) during osteotomy, and to analyze the different radiographic methods reported in the literature to measure medial and lateral tibial slope. The authors postulated that differences in reported normal values of tibial slope in the sagittal plane were technique dependent. Study Design Descriptive laboratory study Methods The proximal anteromedial tibial cortex obliquity on magnetic resonance imaging was measured in 35 knees. Serial computed tomography images of the proximal tibia were digitized, allowing a series of virtual opening wedge osteotomies to be performed. Algebraic calculations defined the effect of an opening wedge osteotomy on the anteromedial tibial cortex opening wedge angle, sagittal tibial slope angle, and coronal valgus alignment. Results The anteromedial tibial cortex oblique angle at the medial osteotomy site was 45°± 6° and determined, along with the degrees of valgus correction, the degrees of the opening wedge angle in the oblique plane. The anterior osteotomy gap at the tibial tubercle was generally one half of the posteromedial gap to maintain the normal sagittal tibial slope. Every millimeter of gap error at the tibial tubercle resulted in approximately 2° of change in the tibial slope. The width of the buttress plate along the anteromedial tibial cortex was 2 to 3 mm less than the computed coronal valgus posteromedial osteotomy gap to achieve tibiofemoral valgus correction. Conclusions A series of measurements preoperatively and intraoperatively are required to obtain the desired correction of tibial slope and valgus alignment.

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18

Balestro, Jean Christian, Sebastien Lustig, Elvire Servien, David Carmody, and Philippe Neyret. "Opening Wedge Tibial Osteotomy in Genu Recurvatum." Techniques in Knee Surgery 8, no. 2 (June 2009): 126–35. http://dx.doi.org/10.1097/btk.0b013e31819b2e27.

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19

Murphy, Michael S., Ronald L. Linscheid, James H. Dobyns, and Hamlet A. Peterson. "Radial opening wedge osteotomy in Madelung's deformity." Journal of Hand Surgery 21, no. 6 (November 1996): 1035–44. http://dx.doi.org/10.1016/s0363-5023(96)80312-1.

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20

Chahla, Jorge, Justin J. Mitchell, Daniel J. Liechti, Gilbert Moatshe, Travis J. Menge, Chase S. Dean, and Robert F. LaPrade. "Opening- and Closing-Wedge Distal Femoral Osteotomy." Orthopaedic Journal of Sports Medicine 4, no. 6 (June 6, 2016): 232596711664990. http://dx.doi.org/10.1177/2325967116649901.

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21

Dean, Chase S., Jorge Chahla, Samuel G. Moulton, Marco Nitri, Raphael Serra Cruz, and Robert F. LaPrade. "Anterolateral Biplanar Proximal Tibial Opening-Wedge Osteotomy." Arthroscopy Techniques 5, no. 3 (June 2016): e531-e540. http://dx.doi.org/10.1016/j.eats.2016.02.015.

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22

O'Malley, Michael P., Ayoosh Pareek, Patrick J. Reardon, Michael J. Stuart, and Aaron J. Krych. "Distal Femoral Osteotomy: Lateral Opening Wedge Technique." Arthroscopy Techniques 5, no. 4 (August 2016): e725-e730. http://dx.doi.org/10.1016/j.eats.2016.02.037.

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23

THURSTON, A. J. "Pivot Osteotomy for the Correction of Malunion of Metacarpal Neck Fractures." Journal of Hand Surgery 17, no. 5 (October 1992): 580–82. http://dx.doi.org/10.1016/s0266-7681(05)80247-5.

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A new configuration of osteotomy has been developed which combines the principles and benefits of opening and closing wedge osteotomies without the degree of shortening associated with the closing wedge osteotomy and the tension imposed on the soft tissues by the opening wedge osteotomy. It is ideally suited to the correction of angular malunions in the long bones of the hands. Ten osteotomies of malunions of the metacarpals have been performed in nine hands giving good correction of the malunion in all cases.

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24

TSUDA, EIICHI, YASUYUKI ISHIBASHI, KAZUHIRO SASAKI, HIDEKI SATO, and SATOSHI TOH. "OPENING-WEDGE OSTEOTOMY FOR REVISION OF FAILED CLOSING-WEDGE HIGH TIBIAL OSTEOTOMY." Journal of Bone and Joint Surgery-American Volume 86, no. 9 (September 2004): 2045–49. http://dx.doi.org/10.2106/00004623-200409000-00027.

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25

Pipino, Gennaro, Pier Indelli, Domenico Tigani, Giuseppe Maffei, and Davide Vaccarisi. "Opening-wedge high tibial osteotomy: a seven - to twelve-year study." Joints 04, no. 01 (January 2016): 006–11. http://dx.doi.org/10.11138/jts/2016.4.1.006.

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Purpose: medial opening-wedge osteotomy is a widely performed procedure used to treat moderate isolated medial knee osteoarthritis. Historically, the literature has contained reports showing satisfactory midterm results when accurate patient selection and precise surgical techniques were applied. This study was conducted to investigate the clinical and radiographic seven- to twelve-year results of opening-wedge high tibial osteotomy in a consecutive series of patients affected by varus knee malalignment with isolated medial compartment degenerative joint disease. Methods: we reviewed a case series of 147 medial opening-wedge high tibial osteotomies at an average follow-up of 9.5 years. Endpoints for evaluation included the reporting of adverse effects, radiographic evidence of bone union, radiographic changes in the correction angle during union, and clinical and functional final outcomes. Results: good or excellent results were obtained in 94% of the cases: the patients reported no major complications related to the opening-wedge high tibial osteotomy surgical technique, bone graft resorption, implant choice or postoperative rehabilitation protocol. At final follow-up, the average hip-knee angle was 4° of valgus without major loss of correction during the healing process. A statistically significant change in the patellar height was detected postoperatively, with a trend towards patella infera. Conclusions: medial opening-wedge high tibial osteotomy is still a reliable method for correcting varus deformity while producing stable fixation, thus allowing satisfactory stability, adequate bone healing and satisfactory mid- to long-term results. Level of evidence: Level IV, therapeutic cases series.

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26

Ganji, Reza, Maryam Omidvar, Alireza Izadfar, and Seyed Mohammad Alavinia. "Opening wedge high tibial osteotomy using tibial wedge allograft: a case series study." European Journal of Orthopaedic Surgery & Traumatology 23, no. 1 (January 4, 2012): 111–14. http://dx.doi.org/10.1007/s00590-011-0933-4.

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27

Nicholls, Jennifer, and Michelle C. Storey. "Analytic Approximation to the Bounce-average Drift Angle for Gyrosynchrotron-emitting Electrons in the Magnetosphere of V471 Tauri." Publications of the Astronomical Society of Australia 16, no. 2 (1999): 139–46. http://dx.doi.org/10.1071/as99139.

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AbstractNumerical modelling (Nicholls & Storey 1999) suggests that the eclipse of a wedge of enhanced number density of mildly relativistic electrons is responsible for the variations in quiescent radio emission of the binary system V471 Tauri. In the model, the wedge of enhanced density is created by electrons accelerated in the interaction region of the magnetospheres of the two stars, which subsequently drift in azimuth while emitting gyrosynchrotron emission. We present here an analytic approximation to the opening angle of the wedge of enhanced density and show that it is consistent with the opening angle derived from numerical modelling for reasonable values of the input parameters.

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28

Smith, W. Bret, Christopher F. Hyer, William T. DeCarbo, Gregory C. Berlet, and Thomas H. Lee. "Opening Wedge Osteotomies for Correction of Hallux Valgus." Foot & Ankle Specialist 2, no. 6 (October 26, 2009): 277–82. http://dx.doi.org/10.1177/1938640009351239.

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29

Miller, Bruce S., Brian Downie, E. Barry McDonough, and Edward M. Wojtys. "Complications After Medial Opening Wedge High Tibial Osteotomy." Arthroscopy: The Journal of Arthroscopic & Related Surgery 25, no. 6 (June 2009): 639–46. http://dx.doi.org/10.1016/j.arthro.2008.12.020.

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30

El-Assal, Maher A., Yaser E. Khalifa, Mohamed M. Abdel-Hamid, Hatem G. Said, and Hatem M. A. Bakr. "Opening-wedge high tibial osteotomy without bone graft." Knee Surgery, Sports Traumatology, Arthroscopy 18, no. 7 (March 27, 2010): 961–66. http://dx.doi.org/10.1007/s00167-010-1104-6.

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31

Stover, Brian S. "Opening Base Wedge Osteotomies in Hallux Valgus Correction." Clinics in Podiatric Medicine and Surgery 30, no. 3 (July 2013): 307–12. http://dx.doi.org/10.1016/j.cpm.2013.04.003.

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32

Mitchell, Justin J., Chase S. Dean, Jorge Chahla, Gilbert Moatshe, Tyler R. Cram, and Robert F. LaPrade. "Varus-Producing Lateral Distal Femoral Opening-Wedge Osteotomy." Arthroscopy Techniques 5, no. 4 (August 2016): e799-e807. http://dx.doi.org/10.1016/j.eats.2016.03.009.

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33

Spahn, Gunter. "Complications in high tibial (medial opening wedge) osteotomy." Archives of Orthopaedic and Trauma Surgery 124, no. 10 (September 30, 2003): 649–53. http://dx.doi.org/10.1007/s00402-003-0588-7.

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34

Kim, Jung Ryul, Sung Jin Shin, Sung-Il Wang, and Sang Min Kang. "Comparison of Lateral Opening Wedge Calcaneal Osteotomy and Medial Calcaneal Sliding-opening Wedge Cuboid-closing Wedge Cuneiform Osteotomy for Correction of Planovalgus Foot Deformity in Children." Journal of Foot and Ankle Surgery 52, no. 2 (March 2013): 162–66. http://dx.doi.org/10.1053/j.jfas.2012.12.007.

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35

Kraus, Jonathan C., Michael Ziegele, Mei Wang; Brian C. Law, and Glenn G. Shi. "Peak Contact Stress of TMT-1 Joint after Sequential Correction of Hallux Valgus Using a Proximal Opening Wedge Metatarsal Osteotomy (PMO) and Distal Soft Tissue Procedure." Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0030. http://dx.doi.org/10.1177/2473011420s00305.

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Category: Bunion; Midfoot/Forefoot Introduction/Purpose: The proximal opening wedge metatarsal osteotomy (PMO) of the first metatarsal is a common procedure for the surgical treatment of moderate to severe hallux valgus. Although with a long track record of success, limited work has been dedicated to this procedures effect on the first tarsometatarsal (TMT-1) joint. The purpose of this study is to evaluate the changes in TMT-1 joint contact stress in the diseased and corrected state following an opening wedge osteotomy of the proximal metatarsal. In addition, the effect of a distal soft tissue release (DSTR) was evaluated as it related to both radiographic correction and TMT-1 joint contact stress. Methods: Seven fresh-frozen cadaveric below knee specimens (mean age: 69yrs) with hallux valgus deformities (mean HVA: 31.7+-12.0degs) were obtained for the study. The specimen was loaded up to 400N on an MTS servo hydraulic load frame with the tibia at 90-degree to the neutrally position foot. Joint contact characteristics at TMT-1 joint were measured with a Tekscan pressure sensor (Model6900, 1100psi). A standard proximal metatarsal osteotomy was performed. Various sized metal wedges (3, 5, 7 mm) with locking plates and screws were inserted in the osteotomy for correction. Following initial tests, a complete distal soft tissue release (DSTR) was performed and the specimens were retested. Additionally, dorsoplantar weight bearing (400N) radiograph was obtained for each condition to measure intermetatarsal (IMA) and hallux valgus (HVA) angles. The contact force, area, and peak contact stress were compared among groups using ANOVA and post-hoc multiple comparisons over the untreated (Dunnett test, p<0.05). Results: The mean HVA decreased with wedge size and DSTR, reached to significant level with 7mm+DSTR (24.1 degs). The mean contact force was 39.7+-32.6 N for untreated specimens. This increased sequentially with opening wedge size and reached statistical significance 7mm opening-wedge (119.6+-53.8 N, p=0.03) and 7mm-wedge+DSTR (116.7+-58.3 N, p=0.04). The peak contact stress followed a similar trend (Figure 1). The mean peak contact stress was 2.3+-1.5 MPa for the untreated specimens and increased incrementally with wedge size to 5.3+-2.6 MPa for 7mm-wedge only (p=0.03) and 5.2+-2.1 MPa for 7mm- wedge+DSTR (p=0.04). Contact area increased with corrections, but none reached significance. Conclusion: The results from this study demonstrate that with sequentially increasing opening wedge size, loading properties through the TMT-1 joint increase. Prior work has demonstrated that joint stresses of over 4.7 MPa can be chondrotoxic, a value which was surpassed with our peak contact stress with the 7mm wedge. This has significant implications for the long-term health of the TMT-1 joint following PMO, potentially predisposing patients to arthritic joint changes. The optimal degree of correction with PMO to limit chondrotoxicity is not known at this time, and is a direction for future work.

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36

Lustig, Sebastien, Elvire Servien, Cecile Batailler, Philippe Neyret, and Simone Cerciello. "Correction of Tibial Valgus Deformity." Journal of Knee Surgery 30, no. 05 (June 2017): 421–25. http://dx.doi.org/10.1055/s-0037-1603504.

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AbstractValgus tibial malalignment may be the result of bony deformity, previous lateral meniscectomy, or lateral plateau fractures. The correction of such a problem is usually addressed through a tibial osteotomy, which affects the alignment both in flexion and extension. Two surgical options are available: medial closing wedge and lateral opening wedge. When planning a varisation osteotomy, it should be considered that the normal joint line is in 3 degrees of varus. Increasing this obliquity beyond 10 to 15 degrees ends up with increased loads on the patellofemoral joint and medial subluxation of the femur on the tibia. The aim of the present study was to discuss actual indications and contraindications for a varus-producing high tibial osteotomy and describe surgical steps of both medial closing wedge and lateral opening wedge techniques. In addition, the available literature has been searched to report functional outcomes and complications.

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37

Sochu, W., N. Noraphaiphipaksa, A. Manonukul, and C. Kanchanomai. "Determination of Crack-Tip Opening Displacement in T-Type Wedge Opening Loaded Specimen." Experimental Mechanics 60, no. 2 (October 19, 2019): 145–52. http://dx.doi.org/10.1007/s11340-019-00543-x.

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38

Chang, Kao-Wha, Ying-Yu Chen, Chien-Chung Lin, Hsiang-Lan Hsu, and Ke-Chun Pai. "Closing Wedge Osteotomy Versus Opening Wedge Osteotomy in Ankylosing Spondylitis With Thoracolumbar Kyphotic Deformity." Spine 30, no. 14 (July 2005): 1584–93. http://dx.doi.org/10.1097/01.brs.0000170300.17082.49.

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39

Randhawa, Sunil, and Dean Pepper. "Radiographic Evaluation of Hallux Valgus Treated with Opening Wedge Osteotomy." Foot & Ankle International 30, no. 5 (May 2009): 427–31. http://dx.doi.org/10.3113/fai-2009-0427.

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Background: There are many techniques described for treatment of hallux valgus. The role of proximal osteotomies of the 1st metatarsal is well documented. However the opening wedge osteotomy has become less popular in contemporary practice. The purpose of this paper was to report our experience with an opening wedge osteotomy for the treatment of hallux valgus using L-Plate fixation. Materials and Methods: Twenty-nine patients underwent 31 basal opening wedge osteotomies of the first metatarsal. Fixation was achieved with the Arthrex® low profile titanium plate. The IMA on the WB radiograph preoperatively, and at least 12 months postoperatively was measured. Four patients received a 3.5-mm plate, 15 received a 4.0-mm plate, and 12 received a 5.0-mm plate. Results: The 3.5-mm group had a mean preoperative IMA of 13.8 degrees (range, 6 to 18), and postoperative IMA of 5.8 (range, 3 to 8), with a mean correction of 8.0. The 4.0-mm plate group had a mean preoperative IMA of 16.9 (range, 11 to 30) and postoperative IMA of 8.9 (range, 4 to 11) with a mean correction of 9.0. The 5.0-mm plate group had a mean preoperative IMA of 24.7 (range, 15 to 35) and postoperative IMA of 9.8, (range, 3 to 22) with a mean correction of 14.9. Conclusion: We report on a successful method for correcting hallux valgus with a basilar first metatarsal opening wedge osteotomy. It was highly effective for correcting moderate to severe intermetatarsal deformities.

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Limbird, T. J., R. M. DaSilva, and N. E. Green. "Osteotomy of the First Metatarsal Base for Metatarsus Primus Varus." Foot & Ankle 9, no. 4 (February 1989): 158–62. http://dx.doi.org/10.1177/107110078900900402.

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An opening wedge osteotomy of the first metatarsal base using either iliac crest bone or the removed exostosis as a graft was used to treat metatarsus primus varus in 22 feet of 15 patients. The preoperative intermetatarsal angle averaged 15°, with the final angle averaging 8°. All osteotomies healed in 3 months with excellent cosmetic and functional results and no difference between iliac crest and exostosis grafts. We conclude that an opening wedge osteotomy of the first metatarsal base is a satisfactory method for the correction of metatarsus primus varus.

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Kozhevnikova, G. V., V. Ya Shchukin, and S. S. Dubianets. "Criteria for opening an axial cavity in cross-wedge rolling." Proceedings of the National Academy of Sciences of Belarus, Physical-Technical Series 67, no. 4 (January 2, 2023): 370–78. http://dx.doi.org/10.29235/1561-8358-2022-67-4-370-378.

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The application of empirical, phenomenological deformation and energy theories of metal fracture in relation to the process of cross-wedge rolling is considered. A distinctive feature of cross-wedge rolling in comparison with other metal pressure treatment processes is the complex stress-strain state in the deformation focus and the possibility of opening the axial cavity. The existing empirical criteria of destruction are given. The scheme of a new calibration test based on crosswedge rolling and the fracture criterion proposed by Zbigniew Pater are considered. It is shown that the Zbigniew Pater’s empirical criterion for the destruction of Zbigniew Pater provides a correct determination of the moment of opening the cavity during cross-wedge rolling. The improved phenomenological deformation theory is based on the theory of fracture developed by V. L. Kolmogorov. It is proposed to evaluate the plasticity of the metal depending on the stress state in the form of two independent invariants of the stress tensor: the average stress and the parameter of the third invariant of the stress tensor. The dependence of the limit value of accumulated deformation, at which destruction occurs, on the stress state is constructed in the form of a plasticity surface. The phenomenological deformation criterion of metal destruction during plastic deformations allows us to determine the moment of opening the cavity during cross-wedge rolling and the plasticity resource of the metal.

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Tan, Si Heng Sharon, Si Jian Hui, Chintan Doshi, Keng Lin Wong, Andrew Kean Seng Lim, and James Hoipo Hui. "The Outcomes of Distal Femoral Varus Osteotomy in Patellofemoral Instability: A Systematic Review and Meta-Analysis." Journal of Knee Surgery 33, no. 05 (March 1, 2019): 504–12. http://dx.doi.org/10.1055/s-0039-1681043.

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AbstractDistal femoral varus osteotomies have been novelly described in the recent years to be successful in the management of patellofemoral instability with genu valgum. However, these publications are limited to case reports and small case series and no published literature have attempted to analyze them in totality. The current review aims to pool together these small case series to evaluate the outcomes and complications of distal varus femoral osteotomies when performed for patellofemoral instability. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. All studies that reported the outcomes of distal femoral varus osteotomy for patellofemoral instability were included. A total of five publications were included in the review, which included a total of 73 patients. All of the studies reported improvement in the radiological outcomes for genu valgum correction and patellofemoral instability. One study using opening wedge osteotomy reported a decrease in Caton–Deschamps index postoperatively, while another study using closing wedge osteotomy reported maintenance of the Caton–Deschamps index postoperatively. Second look arthroscopy showed an improvement in the status of the chondral lesions of the medial facet of the patellar undersurface, the lateral facet of the patellar undersurface and the trochlear groove 2 years postoperatively. All studies also reported a decrease in the risk of recurrence of patellofemoral instability, reduction in pain, and an improvement in all the clinical outcomes knee scores. Distal femoral varus osteotomy is promising and useful in the management of patellofemoral instability with genu valgum. The procedure can allow for radiological correction of the genu valgum and patellofemoral instability, reduction in the risk of recurrence of patellofemoral instability, reduction in pain, improvement in clinical knee outcome scores, and improvement in the status of the chondral lesions in the patellofemoral joint. It is highly versatile and could accommodate varying degrees of correction. These improvements in radiological and clinical outcomes can be seen in studies for both closing wedge and opening wedge distal femoral osteotomies. However, opening wedge osteotomies appear to decrease the patellar height as compared with closing wedge osteotomies which maintain the patellar height; therefore, the patellar height should be assessed preoperatively prior to deciding whether to perform an opening wedge or closing wedge distal femoral varus osteotomy. The Level of Evidence for this study is IV.

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Dietrick, Todd B., and William D. Bugbee. "Distal Femoral Osteotomy Utilizing a Lateral Opening-Wedge Technique." Techniques in Knee Surgery 4, no. 3 (September 2005): 186–92. http://dx.doi.org/10.1097/01.btk.0000175881.99745.78.

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Hunter, Robert E. "Opening-Wedge Proximal Tibial Osteotomies for the Varus Knee." Techniques in Knee Surgery 7, no. 1 (March 2008): 61–67. http://dx.doi.org/10.1097/btk.0b013e318160ea51.

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El Amrani, M. H., B. Lévy, S. Scharycki, and A. Asselineau. "Patellar height relevance in opening-wedge high tibial osteotomy." Orthopaedics & Traumatology: Surgery & Research 96, no. 1 (February 2010): 37–43. http://dx.doi.org/10.1016/j.otsr.2009.10.009.

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Valkering, Kars, Michel Bekerom, Floor Kappelhoff, and G. H. Albers. "Complications After TomoFix Medial Opening Wedge High Tibial Osteotomy." Journal of Knee Surgery 22, no. 03 (2009): 218–25. http://dx.doi.org/10.1055/s-0030-1247752.

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Erak, Sani, Douglas Naudie, Steven J. MacDonald, Richard W. McCalden, Cecil H. Rorabeck, and Robert B. Bourne. "Total knee arthroplasty following medial opening wedge tibial osteotomy." Knee 18, no. 6 (December 2011): 499–504. http://dx.doi.org/10.1016/j.knee.2010.11.002.

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Silva, Carlos Francisco Bittencourt, Eduardo Kastrup Bittencourt Camara, Luiz Antonio Vieira, Fernando Adolphsson, and Rodrigo Ribeiro Pinho Rodarte. "RADIOGRAPHIC ASSESSMENT OF THE OPENING WEDGE PROXIMAL TIBIAL OSTEOTOMY." Revista Brasileira de Ortopedia (English Edition) 45, no. 4 (July 2010): 439–43. http://dx.doi.org/10.1016/s2255-4971(15)30394-3.

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Morin, Vincent, Régis Pailhé, Brice Rubens Duval, Roch Mader, Jérémy Cognault, René-Christopher Rouchy, and Dominique Saragaglia. "Gait analysis following medial opening-wedge high tibial osteotomy." Knee Surgery, Sports Traumatology, Arthroscopy 26, no. 6 (March 1, 2017): 1838–44. http://dx.doi.org/10.1007/s00167-017-4421-1.

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d'Entremont, Agnes G., Kenard Agbanlog, Simon Horlick, Mojieb G. Manzary, Trevor Stone, Robert G. McCormack, and David R. Wilson. "Opening-Wedge High Tibial Osteotomy Changes 3D Knee Kinematics." Arthroscopy: The Journal of Arthroscopic & Related Surgery 29, no. 10 (October 2013): e55-e56. http://dx.doi.org/10.1016/j.arthro.2013.07.039.

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