Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation
Abstract Background The ascending or descending extended biplanar tibial cut in open wedge high tibial osteotomy (owHTO) not only changes the lower limb anatomy in the coronal plane but also leads to different three-dimensional (3D) changes in the patellofemoral joint. This study aimed to perform a...
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BMC
2024-11-01
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| Series: | Knee Surgery & Related Research |
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| Online Access: | https://doi.org/10.1186/s43019-024-00244-3 |
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| author | Maximilian Jörgens Sonja Ehreiser Lennart Schroeder Julius Watrinet Wolfgang Böcker Boris Michael Holzapfel Klaus Radermacher Julian Fürmetz |
| author_facet | Maximilian Jörgens Sonja Ehreiser Lennart Schroeder Julius Watrinet Wolfgang Böcker Boris Michael Holzapfel Klaus Radermacher Julian Fürmetz |
| author_sort | Maximilian Jörgens |
| collection | DOAJ |
| description | Abstract Background The ascending or descending extended biplanar tibial cut in open wedge high tibial osteotomy (owHTO) not only changes the lower limb anatomy in the coronal plane but also leads to different three-dimensional (3D) changes in the patellofemoral joint. This study aimed to perform a comprehensive analysis of the dynamic biomechanical changes in the knee joint using a multibody simulation model. Methods Thirteen 3D computer models derived from lower limb computer tomography scans were used for owHTO. Osteotomies with ascending or descending biplanar cut were simulated for each wedge height from 6 to 12 mm (in 1-mm intervals). Multibody simulation was used to analyze differences in patellar shift, patellar tilt, mediolateral patellar rotation, and tibiofemoral rotation during a squat simulation from 5° to 100° knee flexion. Results The main effects of an ascending compared with a descending extended biplanar cut in owHTO were characterized by an increase in lateralization of the patella and rotation, along with reduced tilt. Linear mixed models revealed statistically significant effects of both wedge height and cut variant on knee kinematics at 100° knee flexion, with the influence of the cut variant (ascending/descending) being higher on all analyzed kinematic parameters. Conclusions Significant differences in the changes in patellofemoral shift, tilt, rotation, and tibiofemoral rotation were observed when performing owHTO with an ascending versus a descending biplanar cut. Apart from tibiofemoral rotation, the resulting kinematic changes were greater with an ascending cut. |
| format | Article |
| id | doaj-art-5f97203da4f149d1bd3d10ead7a9a75d |
| institution | Kabale University |
| issn | 2234-2451 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Knee Surgery & Related Research |
| spelling | doaj-art-5f97203da4f149d1bd3d10ead7a9a75d2024-11-24T12:31:17ZengBMCKnee Surgery & Related Research2234-24512024-11-0136111010.1186/s43019-024-00244-3Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulationMaximilian Jörgens0Sonja Ehreiser1Lennart Schroeder2Julius Watrinet3Wolfgang Böcker4Boris Michael Holzapfel5Klaus Radermacher6Julian Fürmetz7Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMUChair of Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen UniversityDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMUDepartment of Trauma Surgery, BG Unfallklinik MurnauDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMUDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMUChair of Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen UniversityDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMUAbstract Background The ascending or descending extended biplanar tibial cut in open wedge high tibial osteotomy (owHTO) not only changes the lower limb anatomy in the coronal plane but also leads to different three-dimensional (3D) changes in the patellofemoral joint. This study aimed to perform a comprehensive analysis of the dynamic biomechanical changes in the knee joint using a multibody simulation model. Methods Thirteen 3D computer models derived from lower limb computer tomography scans were used for owHTO. Osteotomies with ascending or descending biplanar cut were simulated for each wedge height from 6 to 12 mm (in 1-mm intervals). Multibody simulation was used to analyze differences in patellar shift, patellar tilt, mediolateral patellar rotation, and tibiofemoral rotation during a squat simulation from 5° to 100° knee flexion. Results The main effects of an ascending compared with a descending extended biplanar cut in owHTO were characterized by an increase in lateralization of the patella and rotation, along with reduced tilt. Linear mixed models revealed statistically significant effects of both wedge height and cut variant on knee kinematics at 100° knee flexion, with the influence of the cut variant (ascending/descending) being higher on all analyzed kinematic parameters. Conclusions Significant differences in the changes in patellofemoral shift, tilt, rotation, and tibiofemoral rotation were observed when performing owHTO with an ascending versus a descending biplanar cut. Apart from tibiofemoral rotation, the resulting kinematic changes were greater with an ascending cut.https://doi.org/10.1186/s43019-024-00244-3Open wedge high tibial osteotomyBiplanar cutMultibody simulationBiomechanics of the kneePatellofemoral tracking |
| spellingShingle | Maximilian Jörgens Sonja Ehreiser Lennart Schroeder Julius Watrinet Wolfgang Böcker Boris Michael Holzapfel Klaus Radermacher Julian Fürmetz Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation Knee Surgery & Related Research Open wedge high tibial osteotomy Biplanar cut Multibody simulation Biomechanics of the knee Patellofemoral tracking |
| title | Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation |
| title_full | Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation |
| title_fullStr | Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation |
| title_full_unstemmed | Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation |
| title_short | Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation |
| title_sort | increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy a multibody simulation |
| topic | Open wedge high tibial osteotomy Biplanar cut Multibody simulation Biomechanics of the knee Patellofemoral tracking |
| url | https://doi.org/10.1186/s43019-024-00244-3 |
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