2015 ISAKOS Biennial Congress ePoster #1713

Differences in Alternative Strategies of Preoperative Planning for High Tibial Osteotomy

Anthony Thayaparan, MBChB, Cardiff UNITED KINGDOM
Kathryn Dayananda, MBChB, Cardiff UNITED KINGDOM
David W. Elson, MBChB, MRCS, FRCS (T&O), Newcastle upon Tyne, Tyne & Wear UNITED KINGDOM
Chris Wilson, FRCS, Cardiff UNITED KINGDOM

Cardiff and Vale UHB, Cardiff, UNITED KINGDOM

FDA Status Not Applicable

Summary: When a systematic bias towards under correction was identified we retrospectively explored how different planning methods may have influenced the correction achieved. Planning using Miniaci's method may have yielded a better correction




Different planning methods have been described prior to high tibial osteotomy but rarely compared in clinical practice.


18 patients were judged to be under-corrected when the Mikulicz point failed to pass 45% of the tibial width. 2 observers annotated pre-operative long leg alignment radiographs over 2 rounds of observation. The alternative planning methods proposed by Dugdale & Noyes / Hernigou and Miniaci were recorded. Observation reliability was established with intraclass correlation coefficients. Means for variables were compared with parametric statistical analysis.


There was excellent reliability between observers with intraclass correlation coefficients exceeding 0.879 for all variables. Only a small difference was detected for correction angles (Noyes 10.8°, Miniaci 11.1°, P<0.000). Larger differences were found for opening distances (Hernigou 13.9mm compared to Miniaci 15.1mm, P<0.000)


In a sample known to be under-corrected. Miniaci planning offers a larger correction angle which may be a better choice to increase surgical accuracy. Meticulous surgical attention must be paid to the maintenance of opening distance to increase the accuracy of correction achieved.