ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
Surgical anatomy of medial open-wedge high tibial osteotomy: crucial steps and pitfalls.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 25 citations in OpenAlex.
- Risk Factors and Clinical Outcomes of Osteotomy Plane Violation by D-Hole Screws in Medial Open Wedge High Tibial Osteotomy: A Simulation and Comparative Study.Medicina (Kaunas, Lithuania) · 2023Trial
- Effect of Pes Anserinus Release on Postoperative Pain and Medial Stability in Medial Opening Wedge High Tibial Osteotomy.Medicina (Kaunas, Lithuania) · 2026Article
- Influence of Alignment Changes in Different Planes During Supra-Tubercular Biplanar Medial Opening Wedge High Tibial Osteotomy on Tibial Tubercle-Trochlear Groove Distance.Orthopaedic surgery · 2025Article
- Monocortical fixation for locking plate distal screws does not impair mechanical properties in open-wedge high tibial osteotomy.BMC musculoskeletal disorders · 2021Article
- Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Deep peroneal nerve has a potential risk of injury during open-wedge high tibial osteotomy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Retaining the medial collateral ligament in high tibial medial open-wedge osteotomy mostly results in post-operative intra-articular gap reduction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Deep peroneal nerve injury during plate fixation for medial open-wedge high tibial osteotomy: A case report and cadaveric study.Clinical case reports · 2019Article
- Release of the medial collateral ligament is mandatory in medial open-wedge high tibial osteotomy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
- Advances in modern osteotomies around the knee : Report on the Association of Sports Traumatology, Arthroscopy, Orthopaedic surgery, Rehabilitation (ASTAOR) Moscow International Osteotomy Congress 2017.Journal of experimental orthopaedics · 2019Review
- Posteromedially placed plates with anterior staple reinforcement are not successful in decreasing tibial slope in opening-wedge proximal tibial osteotomy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017Article
- [Medial opening wedge high tibial osteotomy].Operative Orthopadie und Traumatologie · 2017Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo give an overview of the basic knowledge of the functional surgical anatomy of the proximal lower leg and the popliteal region relevant to medial high tibial osteotomy (HTO) as key anatomical structures in spatial relation to the popliteal region and the proximal tibiofibular joint are usually not directly visible and thus escape a direct inspection.
methodsThe surgical anatomy of the human proximal lower leg and its relevance for HTO are illustrated with a special emphasis on the individual steps of the operation involving creation of the osteotomy planes and plate fixation.
resultsThe posteriorly located popliteal neurovascular bundle, but also lateral structures such as the peroneal nerve, the head of the fibula and the lateral collateral ligament must be protected from the instruments used for osteotomy. Neither positioning the knee joint in flexion, nor the posterior thin muscle layer of the popliteal muscle offers adequate protection of the popliteal neurovascular bundle when performing the osteotomy. Tactile feedback through a loss-of-resistance when the opposite cortex is perforated is only possible when sawing and drilling is performed in a pounding fashion. Kirschner wires with a proximal thread, therefore, always need to be introduced under fluoroscopic control. Due to anatomy of the tibial head, the tibial slope may increase inadvertently.
conclusionsEnhanced surgical knowledge of anatomical structures that are at a potential risk during the different steps of osteotomy or plate fixation will help to avoid possible injuries. LEVEL OF EVIDENCE: Expert opinion, Level V.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.