High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures

Background: Inadequate deformity analysis and planning before high tibial osteotomy (HTO) may result in correction errors with unsatisfactory clinical results. Indications: The purpose of this article is to describe the deformity analysis and preoperative planning before HTO. This surgery is effecti...

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Autores principales:	Grégoire Micicoi MD-PHD, Pierre Martz MD-PHD, Christophe Jacquet MD, Levi Reina Fernandes MD, Raghbir Khakha MD, Matthieu Ollivier MD-PHD, Prof.
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Sports medicine RC1200-1245 Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/89d334e1908e4be79311f83619525c13
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spelling	oai:doaj.org-article:89d334e1908e4be79311f83619525c132021-11-30T23:33:19ZHigh Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures2635-025410.1177/26350254211032968https://doaj.org/article/89d334e1908e4be79311f83619525c132021-10-01T00:00:00Zhttps://doi.org/10.1177/26350254211032968https://doaj.org/toc/2635-0254Background: Inadequate deformity analysis and planning before high tibial osteotomy (HTO) may result in correction errors with unsatisfactory clinical results. Indications: The purpose of this article is to describe the deformity analysis and preoperative planning before HTO. This surgery is effective for young patients with compartmental mild knee osteoarthritis. A partial deformity analysis without considering the femoral or intra-articular deformity may lead to overcorrection or excessive joint line obliquity. Preoperative planning using the Miniaci method with manual or semiautomated digital measures may help to prevent these types of errors. Technique Description: Landmarks are used at the proximal femoral side, distal condyles, proximal tibial plateau, and talus borders to define angles automatically on PeekMed software. Fujisawa point is determined to be 50% of the length of the proximal tibia, and Miniaci method is performed after defining the weightbearing line. The method can be performed manually or semiautomatically with the software. In this last case, the optimal procedure to be done to correct the malalignment is proposed by the software which automatically does the opening of the osteotomy to match the desired weightbearing axis and displays the size of the wedge in millimeters. Results: The intraobserver and interobserver reproducibility were performed by 2 different analyses and 2 different observers. The precision of the measures was confirmed based on computed tomographic (CT) scan 3-dimensional measures defined as the gold standard. All the intraobserver and interobserver reproducibility correlation coefficients and precision were satisfactory compared with the gold standard. Hip-knee-ankle angle may vary because of weightbearing situations between CT and long-axis x-rays. Discussion/Conclusion: The interest of semiautomated software for angular value measurements is now well recognized, and the inclusion of anatomical landmarks allows accurate and reproducible angular value measurements. Automatic knee osteotomy planning analyzes the metaphyseal deformity of both the tibia and the femur, and the software suggests the optimal procedure with the degree of openness to obtain the desired mechanical axis without creating excessive joint line obliquityGrégoire Micicoi MD-PHDPierre Martz MD-PHDChristophe Jacquet MDLevi Reina Fernandes MDRaghbir Khakha MDMatthieu Ollivier MD-PHD, Prof.SAGE PublishingarticleSports medicineRC1200-1245Orthopedic surgeryRD701-811ENVideo Journal of Sports Medicine, Vol 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sports medicine RC1200-1245 Orthopedic surgery RD701-811
spellingShingle	Sports medicine RC1200-1245 Orthopedic surgery RD701-811 Grégoire Micicoi MD-PHD Pierre Martz MD-PHD Christophe Jacquet MD Levi Reina Fernandes MD Raghbir Khakha MD Matthieu Ollivier MD-PHD, Prof. High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures
description	Background: Inadequate deformity analysis and planning before high tibial osteotomy (HTO) may result in correction errors with unsatisfactory clinical results. Indications: The purpose of this article is to describe the deformity analysis and preoperative planning before HTO. This surgery is effective for young patients with compartmental mild knee osteoarthritis. A partial deformity analysis without considering the femoral or intra-articular deformity may lead to overcorrection or excessive joint line obliquity. Preoperative planning using the Miniaci method with manual or semiautomated digital measures may help to prevent these types of errors. Technique Description: Landmarks are used at the proximal femoral side, distal condyles, proximal tibial plateau, and talus borders to define angles automatically on PeekMed software. Fujisawa point is determined to be 50% of the length of the proximal tibia, and Miniaci method is performed after defining the weightbearing line. The method can be performed manually or semiautomatically with the software. In this last case, the optimal procedure to be done to correct the malalignment is proposed by the software which automatically does the opening of the osteotomy to match the desired weightbearing axis and displays the size of the wedge in millimeters. Results: The intraobserver and interobserver reproducibility were performed by 2 different analyses and 2 different observers. The precision of the measures was confirmed based on computed tomographic (CT) scan 3-dimensional measures defined as the gold standard. All the intraobserver and interobserver reproducibility correlation coefficients and precision were satisfactory compared with the gold standard. Hip-knee-ankle angle may vary because of weightbearing situations between CT and long-axis x-rays. Discussion/Conclusion: The interest of semiautomated software for angular value measurements is now well recognized, and the inclusion of anatomical landmarks allows accurate and reproducible angular value measurements. Automatic knee osteotomy planning analyzes the metaphyseal deformity of both the tibia and the femur, and the software suggests the optimal procedure with the degree of openness to obtain the desired mechanical axis without creating excessive joint line obliquity
format	article
author	Grégoire Micicoi MD-PHD Pierre Martz MD-PHD Christophe Jacquet MD Levi Reina Fernandes MD Raghbir Khakha MD Matthieu Ollivier MD-PHD, Prof.
author_facet	Grégoire Micicoi MD-PHD Pierre Martz MD-PHD Christophe Jacquet MD Levi Reina Fernandes MD Raghbir Khakha MD Matthieu Ollivier MD-PHD, Prof.
author_sort	Grégoire Micicoi MD-PHD
title	High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures
title_short	High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures
title_full	High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures
title_fullStr	High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures
title_full_unstemmed	High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures
title_sort	high tibial osteotomy with miniaci planning using manual and semiautomated digital measures
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/89d334e1908e4be79311f83619525c13
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_version_	1718406214017089536

High Tibial Osteotomy With Miniaci Planning Using Manual and Semiautomated Digital Measures

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