Download PDF
CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2017; 58(02): 048-058
DOI: 10.1055/s-0037-1606127
Review Article | Artículo de Revisión
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Razonamiento Quirúrgico en Inestabilidad Crónica Posterolateral de Rodilla

Surgical Rationale in Chronic Posterolateral Knee Injury
Pedro Alejandro Díaz Allende
1   Traumatólogo, Servicio Ortopedia y Traumatología Hospital Ricardo Valenzuela Sáez, Rengo, Chile
› Author Affiliations
Further Information

Publication History

19 March 2017

18 July 2017

Publication Date:
23 August 2017 (online)

   Permissions and Reprints

Resumen

Los pacientes con mal alineamiento en varo pueden ser difíciles de tratar cuando tienen una lesión crónica de la esquina posterolateral (EPL), resultando en doble o triple varo y subsecuentemente varus thrust durante la marcha. Una osteotomía tibial alta es un procedimiento útil y necesario particularmente en el estadío crónico. Este artículo revisa los fundamentos de la planificación preoperatoria en una lesión crónica de la EPL.

Abstract

Patients with varus malalignment can be difficult to manage when they have a chronic injury to the posterolateral corner (PLC), resulting in double or triple varus and subsequent varus thrust during gait. A high tibial osteotomy is a useful and necessary procedure particularly in the chronic setting. This article reviews the basics of preoperative planning in a chronic injury of the PLC.

Palabras Clave

esquina posterolateral - inestabilidad crónica - osteotomía en doble nivel - osteotomía tibial alta - planificación preoperatoria - rodilla

Keywords

chronic instability - double level osteotomy - high tibial osteotomy - knee - posterolateral corner - preoperative planning

Declaración y Verificación de la Presentación

Este trabajo no ha sido previamente publicado ni presentado simultáneamente en otra revista y tiene la autorización del autor y su establecimiento asistencial.


 

  • Bibliografía

  • 1 Amis AA. Biomechanics of high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 2013; 21 (01) 197-205
    CrossrefPubMedGoogle Scholar
  • 2 Dejour H, Bonnin M. Tibial translation after anterior cruciate ligament rupture. Two radiological tests compared. J Bone Joint Surg Br 1994; 76 (05) 745-749
    CrossrefPubMedGoogle Scholar
  • 3 Moore TM, Harvey Jr JP. Roentgenographic measurement of tibial-plateau depression due to fracture. J Bone Joint Surg Am 1974; 56 (01) 155-160
    CrossrefPubMedGoogle Scholar
  • 4 Brazier J, Migaud H, Gougeon F, Cotten A, Fontaine C, Duquennoy A. [Evaluation des méthodes de mesure radiographique de la pente tibiale. Analyse de 83 genoux témoins]. Rev Chir Orthop Repar Appar Mot 1996; 82 (03) 195-200
    PubMedGoogle Scholar
  • 5 Hohmann E, Bryant A, Imhoff AB. The effect of closed wedge high tibial osteotomy on tibial slope: a radiographic study. Knee Surg Sports Traumatol Arthrosc 2006; 14 (05) 454-459
    CrossrefPubMedGoogle Scholar
  • 6 Giffin JR, Stabile KJ, Zantop T, Vogrin TM, Woo SL, Harner CD. Importance of tibial slope for stability of the posterior cruciate ligament deficient knee. Am J Sports Med 2007; 35 (09) 1443-1449
    CrossrefPubMedGoogle Scholar
  • 7 Liu-Barba D, Hull ML, Howell SM. Coupled motions under compressive load in intact and ACL-deficient knees: a cadaveric study. J Biomech Eng 2007; 129 (06) 818-824
    CrossrefPubMedGoogle Scholar
  • 8 Agneskirchner JD, Hurschler C, Stukenborg-Colsman C, Imhoff AB, Lobenhoffer P. Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004. Arch Orthop Trauma Surg 2004; 124 (09) 575-584
    CrossrefPubMedGoogle Scholar
  • 9 Rodner CM, Adams DJ, Diaz-Doran V. , et al. Medial opening wedge tibial osteotomy and the sagittal plane: the effect of increasing tibial slope on tibiofemoral contact pressure. Am J Sports Med 2006; 34 (09) 1431-1441
    CrossrefPubMedGoogle Scholar
  • 10 Noyes FR, Goebel SX, West J. Opening wedge tibial osteotomy: the 3-triangle method to correct axial alignment and tibial slope. Am J Sports Med 2005; 33 (03) 378-387
    CrossrefPubMedGoogle Scholar
  • 11 Petrigliano FA, Suero EM, Voos JE, Pearle AD, Allen AA. The effect of proximal tibial slope on dynamic stability testing of the posterior cruciate ligament- and posterolateral corner-deficient knee. Am J Sports Med 2012; 40 (06) 1322-1328
    CrossrefPubMedGoogle Scholar
  • 12 Marti CB, Gautier E, Wachtl SW, Jakob RP. Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy 2004; 20 (04) 366-372
    CrossrefPubMedGoogle Scholar
  • 13 Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD. Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 2004; 32 (02) 376-382
    CrossrefPubMedGoogle Scholar
  • 14 Dugdale TW, Noyes FR, Styer D. Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 1992; (274) 248-264
    PubMedGoogle Scholar
  • 15 Lee DH, Park SC, Park HJ, Han SB. Effect of soft tissue laxity of the knee joint on limb alignment correction in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 2016; 24 (12) 3704-3712
    CrossrefPubMedGoogle Scholar
  • 16 Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 1979; 10 (03) 585-608
    CrossrefPubMedGoogle Scholar
  • 17 Agneskirchner JD, Hurschler C, Wrann CD, Lobenhoffer P. The effects of valgus medial opening wedge high tibial osteotomy on articular cartilage pressure of the knee: a biomechanical study. Arthroscopy 2007; 23 (08) 852-861
    CrossrefPubMedGoogle Scholar
  • 18 Müller M, Strecker W. Arthroscopy prior to osteotomy around the knee?. Arch Orthop Trauma Surg 2008; 128 (11) 1217-1221
    CrossrefPubMedGoogle Scholar
  • 19 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43-B: 752-757
    CrossrefPubMedGoogle Scholar
  • 20 Chao EY, Neluheni EV, Hsu RW, Paley D. Biomechanics of malalignment. Orthop Clin North Am 1994; 25 (03) 379-386
    CrossrefPubMedGoogle Scholar
  • 21 Hsu RW, Himeno S, Coventry MB, Chao EY. Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 1990; (255) 215-227
    PubMedGoogle Scholar
  • 22 Cooke TD, Li J, Scudamore RA. Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am 1994; 25 (03) 387-393
    PubMedGoogle Scholar
  • 23 Moreland JR, Bassett LW, Hanker GJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am 1987; 69 (05) 745-749
    CrossrefPubMedGoogle Scholar
  • 24 Paley D, Tetsworth K. Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res 1992; (280) 48-64
    PubMedGoogle Scholar
  • 25 Fabricant PD, Camara JM, Rozbruch SR. Femoral deformity planning: intentional placement of the apex of deformity. Orthopedics 2013; 36 (05) e533-e537
    CrossrefPubMedGoogle Scholar
  • 26 Gaasbeek RD, Sonneveld H, van Heerwaarden RJ, Jacobs WC, Wymenga AB. Distal tuberosity osteotomy in open wedge high tibial osteotomy can prevent patella infera: a new technique. Knee 2004; 11 (06) 457-461
    CrossrefPubMedGoogle Scholar
  • 27 Bito H, Takeuchi R, Kumagai K. , et al. Opening wedge high tibial osteotomy affects both the lateral patellar tilt and patellar height. Knee Surg Sports Traumatol Arthrosc 2010; 18 (07) 955-960
    CrossrefPubMedGoogle Scholar
  • 28 Pape D, Lorbach O, Schmitz C. , et al. Effect of a biplanar osteotomy on primary stability following high tibial osteotomy: a biomechanical cadaver study. Knee Surg Sports Traumatol Arthrosc 2010; 18 (02) 204-211
    CrossrefPubMedGoogle Scholar
  • 29 Benjamin A. Double osteotomy for the painful knee in rheumatoid arthritis and osteoarthritis. J Bone Joint Surg Br 1969; 51 (04) 694-699
    PubMedGoogle Scholar
  • 30 Iveson JM, Longton EB, Wright V. Comparative study of tibial (single) and tibiofemoral (double) osteotomy for osteoarthrosis and rheumatoid arthritis. Ann Rheum Dis 1977; 36 (04) 319-326
    CrossrefPubMedGoogle Scholar
  • 31 Schüller HM, van Dijk CN, Fidler MW. Poor results of double osteotomy for the rheumatoid knee. Acta Orthop Scand 1987; 58 (03) 253-255
    CrossrefPubMedGoogle Scholar
  • 32 Babis GC, An KN, Chao EY, Rand JA, Sim FH. Double level osteotomy of the knee: a method to retain joint-line obliquity. Clinical results. J Bone Joint Surg Am 2002; 84-A (08) 1380-1388
    PubMedGoogle Scholar
  • 33 Saragaglia D, Mercier N, Colle PE. Computer-assisted osteotomies for genu varum deformity: which osteotomy for which varus?. Int Orthop 2010; 34 (02) 185-190
    CrossrefPubMedGoogle Scholar
  • 34 Saragaglia D, Blaysat M, Mercier N, Grimaldi M. Results of forty two computer-assisted double level osteotomies for severe genu varum deformity. Int Orthop 2012; 36 (05) 999-1003
    CrossrefPubMedGoogle Scholar
  • 35 Saragaglia D, Chedal-Bornu B, Rouchy RC, Rubens-Duval B, Mader R, Pailhé R. Role of computer-assisted surgery in osteotomies around the knee. Knee Surg Sports Traumatol Arthrosc 2016; 24 (11) 3387-3395
    CrossrefPubMedGoogle Scholar
  • 36 Lee YG, Park W, Kim SH. , et al. A case of rhabdomyolysis associated with use of a pneumatic tourniquet during arthroscopic knee surgery. Korean J Intern Med 2010; 25 (01) 105-109
    CrossrefPubMedGoogle Scholar
  • 37 Türkmen İ, Esenkaya İ, Unay K, Akçal MA. Rhabdomyolysis after tourniquet use in proximal tibial osteotomy: a case report and review of the literature. Acta Orthop Traumatol Turc 2015; 49 (03) 338-341
    PubMedGoogle Scholar
  • 38 Melvin JS, Stryker LS, Sierra RJ. Tranexamic Acid in Hip and Knee Arthroplasty. J Am Acad Orthop Surg 2015; 23 (12) 732-740
    CrossrefPubMedGoogle Scholar
  • 39 Xie J, Ma J, Yao H, Yue C, Pei F. Multiple Boluses of Intravenous Tranexamic Acid to Reduce Hidden Blood Loss After Primary Total Knee Arthroplasty Without Tourniquet: A Randomized Clinical Trial. J Arthroplasty 2016; 31 (11) 2458-2464
    CrossrefPubMedGoogle Scholar
  • 40 Sun Q, Yu X, Wu J, Ge W, Cai M, Li S. Efficacy of a Single Dose and an Additional Dose of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty. J Arthroplasty 2017; 32 (07) 2108-2112
    CrossrefPubMedGoogle Scholar
  • 41 Jung TM, Reinhardt C, Scheffler SU, Weiler A. Stress radiography to measure posterior cruciate ligament insufficiency: a comparison of five different techniques. Knee Surg Sports Traumatol Arthrosc 2006; 14 (11) 1116-1121
    CrossrefPubMedGoogle Scholar
  • 42 Yu JS, Salonen DC, Hodler J, Haghighi P, Trudell D, Resnick D. Posterolateral aspect of the knee: improved MR imaging with a coronal oblique technique. Radiology 1996; 198 (01) 199-204
    CrossrefPubMedGoogle Scholar
  • 43 LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G. The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med 2000; 28 (02) 191-199
    CrossrefPubMedGoogle Scholar
  • 44 Badhe NP, Forster IW. High tibial osteotomy in knee instability: the rationale of treatment and early results. Knee Surg Sports Traumatol Arthrosc 2002; 10 (01) 38-43
    CrossrefPubMedGoogle Scholar
  • 45 Arthur A, LaPrade RF, Agel J. Proximal tibial opening wedge osteotomy as the initial treatment for chronic posterolateral corner deficiency in the varus knee: a prospective clinical study. Am J Sports Med 2007; 35 (11) 1844-1850
    CrossrefPubMedGoogle Scholar
  • 46 Noyes FR, Barber-Westin SD, Hewett TE. High tibial osteotomy and ligament reconstruction for varus angulated anterior cruciate ligament-deficient knees. Am J Sports Med 2000; 28 (03) 282-296
    CrossrefPubMedGoogle Scholar
  • 47 Phisitkul P, Wolf BR, Amendola A. Role of high tibial and distal femoral osteotomies in the treatment of lateral-posterolateral and medial instabilities of the knee. Sports Med Arthrosc Rev 2006; 14 (02) 96-104
    CrossrefPubMedGoogle Scholar
  • 48 Naudie DD, Amendola A, Fowler PJ. Opening wedge high tibial osteotomy for symptomatic hyperextension-varus thrust. Am J Sports Med 2004; 32 (01) 60-70
    CrossrefPubMedGoogle Scholar
  • 49 Savarese E, Bisicchia S, Romeo R, Amendola A. Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner. J Orthop Traumatol 2011; 12 (01) 1-17
    PubMedGoogle Scholar
  • 50 LaPrade RF, Morgan PM, Wentorf FA, Johansen S, Engebretsen L. The anatomy of the posterior aspect of the knee. An anatomic study. J Bone Joint Surg Am 2007; 89 (04) 758-764
    CrossrefPubMedGoogle Scholar