title: Impact of medial opening or lateral closing tibial osteotomy on bone resection and posterior cruciate ligament integrity during knee arthroplasty.
abstract: To compare lateral closing to medial opening wedge high tibial osteotomy regarding change in proximal tibial anatomy and PCL tibial attachment integrity after standard tibial arthroplasty resection. Controlled cadaveric study. Ten cadaveric lower limbs received either a 12 degrees lateral closing or 12.5-mm medial opening wedge high tibial osteotomy. Radiographs were performed before and after each osteotomy, and each PCL tibial attachment was dissected. Postosteotomy, tibial arthroplasty resection was performed and the remaining PCL attachment area calculated. Lateral closing wedge specimens demonstrated a greater change in proximal tibial anatomy. After tibial arthroplasty resection, there was a significant difference in remaining PCL tibial attachment percentage area. Proximal tibial anatomy is altered differently for each type of osteotomy despite similar correction angles. Arthroplasty conversion may be more challenging after lateral closing wedge procedures.
authors.affiliation: Department of Orthopaedic Surgery, Austin and Repatriation Hospital, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Whitehead
authors.forename: Kevin
authors.initials: K
authors.lastname: Willits
authors.forename: Dianne
authors.initials: D
authors.lastname: Bryant
authors.forename: J Robert
authors.initials: JR
authors.lastname: Giffin
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Fowler
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D019637:Orthopedic Procedures; D010027:Osteotomy / Q000379:methods*; D016119:Posterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*