ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
Sawing toward the fibular head during open-wedge high tibial osteotomy carries the risk of popliteal artery injury.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05807451 (Anatomic Relationship Of the Popliteal Vessels In Two Types Of Open Wedge High Tibial Osteotomy), which is not on this map. Cited by 9 papers.
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Anatomic Relationship Of the Popliteal Vessels In Two Types Of Open Wedge High Tibial Osteotomy ( Monoplanar VS Biplanar )
Who cites it
9 citing papers in PubMed.
- Avoiding Compartment Syndrome, Vascular Injury, and Neurologic Deficit in Tibial Osteotomy: An Observational Study of 108 Limbs.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Observational
- Medially and distally inserted tuberosity screw fixation of the osteotomized tubercle is safe and effective in retro-tubercular bi-planar opening-wedge high tibial osteotomy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Anatomical implications of the subvastus approach on major vascular injury during a distal femoral osteotomy: a computed tomographic venography study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Iatrogenic injury of the popliteal artery in orthopedic knee surgery: clinical results and development of a therapeutic algorithm.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Reducing the Risk of Neurovascular Injury With Posteromedial Plating and Laterally Directed Screw Insertion During Opening-Wedge High Tibial Osteotomy.Orthopaedic journal of sports medicine · 2022Article
- Analysis of popliteal artery location for high tibial and distal tuberosity osteotomy using contrast-enhanced computed tomography.Knee surgery & related research · 2022Article
- The range of the required anterolateral cortex osteotomy distance varied widely in biplanar open wedge high tibial osteotomy.BMC musculoskeletal disorders · 2022Article
- Surgical Implications of the Arterial Anatomy around the Knee: A Cadaveric Pictorial Essay.Diagnostics (Basel, Switzerland) · 2021Article
- Day-Case Opening Wedge High Tibial Osteotomy With Intraosseous PEEK Implant.Arthroscopy, sports medicine, and rehabilitation · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposePopliteal artery injury is a rare but devastating complication of open-wedge high tibial osteotomy (OWHTO). The objectives of this study were: to document the location of the artery in the virtual osteotomy plane (VOP), to measure the minimal distance between the popliteal artery and three virtual saw-progression lines (VSLs), and to present a safe sawing technique for OWHTO.
methodIn total, 45 computed tomography angiographies were reconstructed and virtual osteotomy was simulated using 3D image-processing software. The VOP was defined as an inclined plane commencing 3.5 cm below the articular plane towards the fibular head. VSLs were defined as saw-progression guidelines that lie on the VOP: "VSL-mid" runs from the midpoint of the tibial medial cortex towards the fibular head; "VSL-ant" starts from the same point as VSL-mid, but runs 10° anterior to the fibular head; and "VSL-post" runs 10° posterior to the fibular head. The distances between the popliteal artery and the three VSLs were measured, and the risk of injury was assessed.
resultsThe popliteal artery was located 20.7° posterior to VSL-mid and 51 mm from the starting point. The minimum distance between the popliteal artery and VSL-mid was 18 mm (99% confidence interval 9-27 mm). When the saw was moved along VSL-mid, 42% of the arteries were susceptible to injury. However, when it followed VSL-ant, there was no risk of injury.
conclusionsSawing toward the fibular head carries a risk of popliteal artery injury and should not be performed. When sawing in OWHTO, the recommended target should be 10° anterior to the fibular head. This technique eliminates the risk of popliteal artery injury.
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Registered trials
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