Articles: tibia-surgery.
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Knee Surg Sports Traumatol Arthrosc · Mar 2006
Primary stability of four different implants for opening wedge high tibial osteotomy.
Since a significant number of implant failures have been reported in association with the procedure of open wedge valgus high tibial osteotomy, the initial biomechanical stability of different fixation devices was investigated in this study. Fifteen third generation Sawbones composite tibiae were used as a model. Four different plates were tested: a short spacer plate (OWO) (n = 4), a short spacer plate with multi-directional locking bolts (MSO) (n = 5), a prototype version of a long spacer plate with multi-directional locking bolts (MSOnew) (n = 2), and a long medial tibia plate fixator with locking bolts (MPF) (n = 4). ⋯ The highest residual stability after failure of the lateral cortex was observed in MPF as well. The results suggest that the implant design strongly influences the primary stability of medial opening wedge tibial osteotomy. A rigid long plate fixator with angle-stable locking bolts yields the best results.
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Comparative Study
Reconstruction of isolated posterior cruciate ligament injuries: a clinical comparison of the transtibial and tibial inlay techniques.
To compare the clinical and stress radiologic results of posterior cruciate ligament (PCL) reconstruction using the transtibial tunnel technique and tibial inlay technique. ⋯ Level III.
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Comparative Study
Effects of parathyroid hormone on newly regenerated bone during distraction osteogenesis in a rabbit tibial lengthening model. A pilot study.
The overall purpose of the study is to determine the effects of parathyroid hormone (PTH) (1-34) on bone formation in regenerated and surrounding bone of distracted callus during limb lengthening in rabbits. Additionally the aim of the pilot study is to titrate the optimal dose of PTH for distraction osteogenesis treatment in rabbits' tibial lengthening model. ⋯ PTH (1-34) treatment improved mineralization, structural indices of regenerated distracted rabbits' tibiae, whereas treatment at a dose of 25 microg/kg/day PTH (1-34) was significantly more effective than 5 microg/kg/day PTH(1-34) dose treatment when compared to control group. Bigger dose has been chosen for the main study.
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Comparative Study
Vascular risk associated with bicortical tibial drilling during anteromedial tibial tubercle transfer.
For select patients with persistent patellofemoral pain, the anteromedial tibial tubercle transfer (Fulkerson osteotomy) provides excellent clinical results. This procedure, indicated for patients with patellar malalignment, has become one of the most popular distal realignment procedures. One potential concern with this technique is the proximity of the posterior vascular structures during bicortical tibial drilling for screw placement. ⋯ Repeat AP radiographs were obtained, and digital calipers were used to measure the distance from the drill bits to the popliteal vessels. The vascular structure closest to the exit point of the superior drill bit was the bifurcation of the popliteal artery (mean distance, 8.3 mm; SD, 9.3 mm; range, 0.0-21.3 mm), and in 2 knees this structure directly overlay the bifurcation on the AP radiograph; the vascular structure closest to the exit point of the inferior drill bit was the posterior tibial artery (mean distance, 9.0 mm; SD, 8.0 mm; range, 0.0-20.0 mm), and again in 2 knees the drill bit lay directly over the artery on the AP radiograph. Bicortical drilling for screw placement during the anteromedial tibial tubercle transfer procedure may come precariously close to the posterior vascular structures of the knee, so orthopedic surgeons must take extreme caution not to drill past the posterior cortex during this part of the operation.
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Knee Surg Sports Traumatol Arthrosc · Oct 2005
Evaluation of patellar height and measurement methods after valgus high tibial osteotomy.
Several controversies exist regarding the surgical difficulties and the results of total knee arthroplasty performed after failed valgus high tibial osteotomy (HTO), and the main subject is the change in patellar height that results as patella baja or infera. The purpose of this retrospective study was to evaluate patellar height after valgus HTO and the measurement methods that were actually used. Eighty-five knees that were subjected to valgus HTO were evaluated both preoperatively and postoperatively according to the Insall-Salvati Index (ISI), Blackburne-Peel Index (BPI), and Caton Index (CI) to assess any alteration of patellar tendon height that was present. ⋯ A significant decrease in patellar height according to ISI suggests that there should be patellar tendon shortening as patellar height cannot be changed. BPI and CI for determining patellar height in valgus HTO do not accurately measure the alteration of patella because they may affect the tibial inclination and antero-posterior translation of the proximal fragment. Another measuring system based on femoral reference points should be proposed to determine the exact change of patellar height in the valgus HTO procedure.