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Kyung Wook Nha - One of the best experts on this subject based on the ideXlab platform.
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early complications of medial opening wedge high tibial osteotomy using autologous tricortical Iliac Bone graft and t plate fixation
Knee, 2011Co-Authors: Dong Ju Chae, Gautam M Shetty, Kook Hyun Wang, Antonio Santa Cruz Montalban, Jong In Kim, Kyung Wook NhaAbstract:Despite several advantages of medial opening wedge high tibial osteotomy, this procedure has been noted to have a high rate of complications especially with the use of a spacer plate for fixation. We retrospectively evaluated the early complications of 138 medial opening wedge high tibial osteotomies done using autologous tricortical Iliac Bone graft and T-plate fixation(AO locking compression T-plate, Ti/3H 4.5-5.0 mm, Synthes, Switzerland, Model No. 440.131 in 30 and low-profile locking T-plate and low-profile locking T-plate in 128 patients. At a mean follow-up of 36.8 months (13 to 78), 26 knees (18.8%) developed complications. Complications varied from osteotomy site infection, loss of correction, broken screws and lateral tibial plateau fracture to joint fluid leakage, pseudoaneurysm and Iliac Bone fractures. Using the "safe zone" technique and penetrating the lateral cortex with Steinmann pins may help to avoid complications such as loss of correction and lateral tibial plateau fractures. The results of this study indicate that medial opening wedge high tibial osteotomy using autologous tricortical Iliac Bone graft and T-plate fixation may be a technically demanding procedure associated with a moderate rate of complications. However, these complications could be minimized with proper planning, adequate intra-operative precautions and few modifications to avoid technical error.
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tibial slope and patellar height after opening wedge high tibia osteotomy using autologous tricortical Iliac Bone graft
Knee, 2008Co-Authors: Dong Ju Chae, Gautam M Shetty, Dong Bong Lee, Hyun Woo Choi, Seung Beom Han, Kyung Wook NhaAbstract:Abstract Our aim was to evaluate the alteration in angle of posterior slope of the tibia and the degree of patellar height following medial opening wedge high tibia osteotomy(HTO) using autologous tricortical Iliac Bone graft in 32 consecutive patients. Twenty three females and nine males underwent medial opening wedge high tibia osteotomy (HTO) using autologous tricortical Iliac Bone graft in 34 knees (33 primary medial compartment osteoarthritis and 1 idiopathic osteonecrosis of medial tibial condyle). The posterior slope of tibia was determined by the proximal tibial anatomical axis. Patellar height was measured by the Insall-Salvati and the Blackburne-Peel ratios. Preoperative and postoperative (last follow up) values of these three parameters were compared. The intra- and interobserver variability of these methods was determined before and after operation. At the end of mean follow up of 3 years this procedure produced no significant change in posterior slope. Pre and postoperative posterior slope were 8.7°±3.6° and 8.2°±2.8° respectively ( P =0.412). Pre and postoperative Insall-Salvati ratios were 0.93±0.10 and 1.05±0.11 respectively ( P The distance between the patellar and tibiofemoral joint line decreased in 82% of patients. The mean Blackburne-Peel ratio declined from 0.71±0.12 to 0.61±0.13 ( P There was no difference in the intra-and interobserver variability of measurements either before or after HTO. Opening wedge HTO using autologous tricortical Iliac Bone graft with internal fixation and early mobilisation prevented change in posterior slope of tibia, lengthened the patellar ligament and elevated the tibiofemoral joint line when the mean ratio of anterior and posterior gap at the osteotomy site was around two-thirds.
Dong Ju Chae - One of the best experts on this subject based on the ideXlab platform.
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early complications of medial opening wedge high tibial osteotomy using autologous tricortical Iliac Bone graft and t plate fixation
Knee, 2011Co-Authors: Dong Ju Chae, Gautam M Shetty, Kook Hyun Wang, Antonio Santa Cruz Montalban, Jong In Kim, Kyung Wook NhaAbstract:Despite several advantages of medial opening wedge high tibial osteotomy, this procedure has been noted to have a high rate of complications especially with the use of a spacer plate for fixation. We retrospectively evaluated the early complications of 138 medial opening wedge high tibial osteotomies done using autologous tricortical Iliac Bone graft and T-plate fixation(AO locking compression T-plate, Ti/3H 4.5-5.0 mm, Synthes, Switzerland, Model No. 440.131 in 30 and low-profile locking T-plate and low-profile locking T-plate in 128 patients. At a mean follow-up of 36.8 months (13 to 78), 26 knees (18.8%) developed complications. Complications varied from osteotomy site infection, loss of correction, broken screws and lateral tibial plateau fracture to joint fluid leakage, pseudoaneurysm and Iliac Bone fractures. Using the "safe zone" technique and penetrating the lateral cortex with Steinmann pins may help to avoid complications such as loss of correction and lateral tibial plateau fractures. The results of this study indicate that medial opening wedge high tibial osteotomy using autologous tricortical Iliac Bone graft and T-plate fixation may be a technically demanding procedure associated with a moderate rate of complications. However, these complications could be minimized with proper planning, adequate intra-operative precautions and few modifications to avoid technical error.
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tibial slope and patellar height after opening wedge high tibia osteotomy using autologous tricortical Iliac Bone graft
Knee, 2008Co-Authors: Dong Ju Chae, Gautam M Shetty, Dong Bong Lee, Hyun Woo Choi, Seung Beom Han, Kyung Wook NhaAbstract:Abstract Our aim was to evaluate the alteration in angle of posterior slope of the tibia and the degree of patellar height following medial opening wedge high tibia osteotomy(HTO) using autologous tricortical Iliac Bone graft in 32 consecutive patients. Twenty three females and nine males underwent medial opening wedge high tibia osteotomy (HTO) using autologous tricortical Iliac Bone graft in 34 knees (33 primary medial compartment osteoarthritis and 1 idiopathic osteonecrosis of medial tibial condyle). The posterior slope of tibia was determined by the proximal tibial anatomical axis. Patellar height was measured by the Insall-Salvati and the Blackburne-Peel ratios. Preoperative and postoperative (last follow up) values of these three parameters were compared. The intra- and interobserver variability of these methods was determined before and after operation. At the end of mean follow up of 3 years this procedure produced no significant change in posterior slope. Pre and postoperative posterior slope were 8.7°±3.6° and 8.2°±2.8° respectively ( P =0.412). Pre and postoperative Insall-Salvati ratios were 0.93±0.10 and 1.05±0.11 respectively ( P The distance between the patellar and tibiofemoral joint line decreased in 82% of patients. The mean Blackburne-Peel ratio declined from 0.71±0.12 to 0.61±0.13 ( P There was no difference in the intra-and interobserver variability of measurements either before or after HTO. Opening wedge HTO using autologous tricortical Iliac Bone graft with internal fixation and early mobilisation prevented change in posterior slope of tibia, lengthened the patellar ligament and elevated the tibiofemoral joint line when the mean ratio of anterior and posterior gap at the osteotomy site was around two-thirds.
Takashi Nakamura - One of the best experts on this subject based on the ideXlab platform.
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pseudoaneurysm of the deep circumflex Iliac artery a rare complication at an anterior Iliac Bone graft donor site
Spine, 2000Co-Authors: Masashi Neo, Mutsumi Matsushita, Toru Morita, Takashi NakamuraAbstract:Study Design. The formation of a pseudoaneurysm of the deep circumflex Iliac artery after the harvesting of an anterior Iliac Bone graft for spinal fusion is reported. Objective. To describe a rate complication at an Iliac Bone graft donor site. Summary of Background Data, the Iliac Bone is a common site for harvesting Bone for spinal surgery. Although many complications have been reported, vascular injurles associated with this procedure are rare. To the authors knowledge, deep circomfiex Iliac artery injury has not been reported as a complication. Methods. A 70-year-old man with cervical myelopathy underwent anterior cervical decompression and fusion with an anterior Iliac Bone graft. Fracture displacement of the anterior superior Iliac spine at the donor site was noted 1 week after a second operation, which was performed to reduce the displaced grafted Bone. Five months after the second operation, he reported pain and swelling at the donor site. Removal of a hematoma was attempted, which led to massive bleeding that was difficult to control, Results. Angiography demonstrated a pseudoaneurysm of the deep circumflex Iliac artery, Selective embolization of the artery was performed, and the bleeding was arrested. Conclusions. Vascular injury after anterion Iliac Bone harvesting is rate but can occur. Selective arterial embolization was an effective soiution.
M Gabl - One of the best experts on this subject based on the ideXlab platform.
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free vascularised Iliac Bone graft for recalcitrant avascular nonunion of the scaphoid
Journal of Bone and Joint Surgery-british Volume, 2010Co-Authors: R Arora, M Lutz, R Zimmermann, D Krappinger, C Niederwanger, M GablAbstract:We report the use of a free vascularised Iliac Bone graft in the treatment of 21 patients (19 men and 2 women) with an avascular nonunion of the scaphoid in which conventional Bone grafting had previously failed. The mean age of the patients was 32 years (23 to 46) and the dominant wrist was affected in 14. The mean interval from fracture to the vascularised Bone grafting was 39 months (9 to 62). Pre-operative MRI showed no contrast enhancement in the proximal fragment in any patient. Fracture union was assessed radiologically or with CT scans if the radiological appearances were inconclusive. At a mean follow-up of 5.6 years (2 to 11) union was obtained in 16 patients. The remaining five patients with a persistent nonunion continued to experience pain, reduced grip strength and limited range of wrist movement. In the successfully treated patients the grip strength and range of movement did not recover to match the uninjured side. Prevention of progressive carpal collapse, the absence of donor site morbidity, good subjective results and pain relief, justifies this procedure in the treatment of recalcitrant nonunion of the scaphoid.
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stage 3 kienbock s disease reconstruction of the fractured lunate using a free vascularized Iliac Bone graft and external fixation
Journal of Hand Surgery (European Volume), 2002Co-Authors: M Gabl, M Lutz, R Zimmermann, Cl Reinhart, S Pechlaner, H Hussl, Michael RiegerAbstract:Eighteen patients with stage 3 Kienbock's disease were treated by debridement of the necrotic core of the lunate and implantation of a free vascularized corticocancellous Iliac Bone. The wrist was stabilized with an external fixator during healing. The efficiency of the procedure for restoring the structure of the fractured lunate, preventing carpal collapse and improving the clinical outcome was assessed at a mean follow-up of 5 years. The graft became incorporated in the lunate in 16 of the 18 patients and no fracture of the reconstructed lunate or carpal collapse occurred in these cases. The graft did not integrate and was resorbed in the other two patients.
Gautam M Shetty - One of the best experts on this subject based on the ideXlab platform.
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early complications of medial opening wedge high tibial osteotomy using autologous tricortical Iliac Bone graft and t plate fixation
Knee, 2011Co-Authors: Dong Ju Chae, Gautam M Shetty, Kook Hyun Wang, Antonio Santa Cruz Montalban, Jong In Kim, Kyung Wook NhaAbstract:Despite several advantages of medial opening wedge high tibial osteotomy, this procedure has been noted to have a high rate of complications especially with the use of a spacer plate for fixation. We retrospectively evaluated the early complications of 138 medial opening wedge high tibial osteotomies done using autologous tricortical Iliac Bone graft and T-plate fixation(AO locking compression T-plate, Ti/3H 4.5-5.0 mm, Synthes, Switzerland, Model No. 440.131 in 30 and low-profile locking T-plate and low-profile locking T-plate in 128 patients. At a mean follow-up of 36.8 months (13 to 78), 26 knees (18.8%) developed complications. Complications varied from osteotomy site infection, loss of correction, broken screws and lateral tibial plateau fracture to joint fluid leakage, pseudoaneurysm and Iliac Bone fractures. Using the "safe zone" technique and penetrating the lateral cortex with Steinmann pins may help to avoid complications such as loss of correction and lateral tibial plateau fractures. The results of this study indicate that medial opening wedge high tibial osteotomy using autologous tricortical Iliac Bone graft and T-plate fixation may be a technically demanding procedure associated with a moderate rate of complications. However, these complications could be minimized with proper planning, adequate intra-operative precautions and few modifications to avoid technical error.
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tibial slope and patellar height after opening wedge high tibia osteotomy using autologous tricortical Iliac Bone graft
Knee, 2008Co-Authors: Dong Ju Chae, Gautam M Shetty, Dong Bong Lee, Hyun Woo Choi, Seung Beom Han, Kyung Wook NhaAbstract:Abstract Our aim was to evaluate the alteration in angle of posterior slope of the tibia and the degree of patellar height following medial opening wedge high tibia osteotomy(HTO) using autologous tricortical Iliac Bone graft in 32 consecutive patients. Twenty three females and nine males underwent medial opening wedge high tibia osteotomy (HTO) using autologous tricortical Iliac Bone graft in 34 knees (33 primary medial compartment osteoarthritis and 1 idiopathic osteonecrosis of medial tibial condyle). The posterior slope of tibia was determined by the proximal tibial anatomical axis. Patellar height was measured by the Insall-Salvati and the Blackburne-Peel ratios. Preoperative and postoperative (last follow up) values of these three parameters were compared. The intra- and interobserver variability of these methods was determined before and after operation. At the end of mean follow up of 3 years this procedure produced no significant change in posterior slope. Pre and postoperative posterior slope were 8.7°±3.6° and 8.2°±2.8° respectively ( P =0.412). Pre and postoperative Insall-Salvati ratios were 0.93±0.10 and 1.05±0.11 respectively ( P The distance between the patellar and tibiofemoral joint line decreased in 82% of patients. The mean Blackburne-Peel ratio declined from 0.71±0.12 to 0.61±0.13 ( P There was no difference in the intra-and interobserver variability of measurements either before or after HTO. Opening wedge HTO using autologous tricortical Iliac Bone graft with internal fixation and early mobilisation prevented change in posterior slope of tibia, lengthened the patellar ligament and elevated the tibiofemoral joint line when the mean ratio of anterior and posterior gap at the osteotomy site was around two-thirds.
