Towards planning of osteotomy around the knee with quantitative inclusion of the adduction moment: a biomechanical approach.

Adduction moment Biomechanics of osteotomy High tibial osteotomy Leg alignment Medial compartment force ratio Supracondylar osteotomy

Journal

Journal of experimental orthopaedics
ISSN: 2197-1153
Titre abrégé: J Exp Orthop
Pays: Germany
ID NLM: 101653750

Informations de publication

Date de publication:
11 Jun 2021
Historique:
received: 27 06 2020
accepted: 06 01 2021
entrez: 11 6 2021
pubmed: 12 6 2021
medline: 12 6 2021
Statut: epublish

Résumé

Despite practised for decades, the planning of osteotomy around the knee, commonly using the Mikulicz-Line, is only empirically based, clinical outcome inconsistent and the target angle still controversial. A better target than the angle of frontal-plane static leg alignment might be the external frontal-plane lever arm (EFL) of the knee adduction moment. Hypothetically assessable from frontal-plane-radiograph skeleton dimensions, it might depend on the leg-alignment angle, the hip-centre-to-hip-centre distance, the femur- and tibia-length. The target EFL to achieve a medial compartment force ratio of 50% during level-walking was identified by relating in-vivo-measurement data of knee-internal loads from nine subjects with instrumented prostheses to the same subjects' EFLs computed from frontal-plane skeleton dimensions. Adduction moments derived from these calculated EFLs were compared to the subjects' adduction moments measured during gait analysis. Highly significant relationships (0.88 ≤ R Osteotomy outcome might be improved by planning re-alignment based on the provided formulas exploiting full-leg-radiograph skeleton dimensions.

Identifiants

pubmed: 34115238
doi: 10.1186/s40634-021-00324-3
pii: 10.1186/s40634-021-00324-3
pmc: PMC8193456
doi:

Types de publication

Journal Article

Langues

eng

Pagination

39

Subventions

Organisme : Deutsche Forschungsgemeinschaft
ID : Be 804/18, TR 1657/1-1, SFB 1444, Da 1786/5-1
Organisme : Deutsche Forschungsgemeinschaft
ID : Be 804/18, TR 1657/1-1, SFB 1444, Da 1786/5-1
Organisme : Bundesministerium für Bildung und Forschung
ID : OVERLOAD-PrevOP, 01EC1408A,01 EC1408A. workHEALTH, 01EC1905D
Organisme : Bundesministerium für Bildung und Forschung
ID : OVERLOAD-PrevOP, 01EC1408A,01 EC1408A. workHEALTH, 01EC1905D

Commentaires et corrections

Type : ErratumIn

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Auteurs

Margit Biehl (M)

Fraunhofer Institute for Biomedical Engineering IBMT, Joseph-von-Fraunhofer-Weg 1, 66280, Sulzbach, Germany. margit.biehl@ibmt.fraunhofer.de.

Philipp Damm (P)

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.

Adam Trepczynski (A)

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.

Stefan Preiss (S)

Lower Extremity Orthopaedics, Musculoskeletal Center, Schulthess Clinic, Zurich, Switzerland.

Gian Max Salzmann (GM)

Lower Extremity Orthopaedics, Musculoskeletal Center, Schulthess Clinic, Zurich, Switzerland.
Gelenkzentrum Rhein-Main, Wiesbaden, Germany.

Classifications MeSH