title: Osteotomy configuration of the proximal wedge and analysis of the affecting factors in the medial open-wedge high tibial osteotomy.
abstract: OBJECTIVE
  The purposes of this study were (1) to confirm the disparity of the measured thickness at the lateral hinge between anterior-posterior (AP) radiograph and 3D CT image, (2) to evaluate the affecting factors, and (3) to evaluate the differences between uniplanar and biplanar osteotomies.
  
  
  METHODS
  From 2012 to 2014, a prospective comparative study was performed with 30 patients who received uniplanar osteotomy (group I) and 35 patients who received biplanar osteotomy (group II). For measurement of the proximal wedge, postoperative AP radiograph and 3D CT images were used. In the AP radiograph, medial and lateral bony bridge thicknesses were measured. In the 3D CT, the anterior and posterior images parallel to the coronal plane were selected for the evaluation. Coronal osteotomy slope was measured with the anterior image of the 3D CT scan. Sagittal osteotomy slope was measured with the sagittal section of the CT scan.
  
  
  RESULTS
  Differences between the lateral bony bridge thicknesses measured in AP radiograph and the posterolateral posterolateral bony bridge thicknesses measured in 3D CT were statistically significant in both groups. Negative correlation was observed in the biplanar osteotomy group. Differences of the sagittal osteotomy slope from the native tibial slope showed negative correlation in the biplanar osteotomy group.
  
  
  CONCLUSIONS
  Thickness of the posterolateral bony bridge was smaller compared to the observed thickness on the AP radiograph image that is routinely used for the follow-up. The thickness would be getting smaller if osteotomy is performed with an abrupt angle on the coronal plane and reverse slope on the sagittal plane. Therefore, osteotomy with abrupt angle on the coronal plane and reverse slope on the sagittal plane should be avoided for the proper thickness of the posterolateral bony bridge.
  
  
  METHODS
  III.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Yong Seuk
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Jong Yeal
authors.initials: JY
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daekak-Ro, Jongno-Gu, Seoul, 110-744, South Korea.
authors.forename: Myung Chul
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Elazab
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Uk Hyun
authors.initials: UH
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Seo Goo
authors.initials: SG
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Kyoung Jae
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daekak-Ro, Jongno-Gu, Seoul, 110-744, South Korea. shlee3219@gmail.com.
authors.forename: Sahnghoon
authors.initials: S
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011184:Postoperative Period; D011446:Prospective Studies; D019736:Prostheses and Implants; D011859:Radiography; D013977:Tibia / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Bony wedge; High tibial osteotomy; Proximal tibia; Thickness