Minimally Invasive High Tibial Osteotomy Using a Patient-Specific Cutting Guide

Hamid Rahmatullah Bin Abd Razak (1) , Christophe Jacquet (2) , Adrian J Wilson (3) , Raghbir S Khakha (4) , Kristian Kley (2) , Sébastien Parratte (2) , Matthieu Ollivier (2)

1 Harley Street Specialist Hospital
2 ISM - Institut des Sciences du Mouvement Etienne Jules Marey
3 University of Winchester
4 Guy's and St Thomas' Hospital [London]

Medial opening wedge high tibial osteotomy (OW-HTO) is an excellent surgical option for patients with varus knee osteoarthritis. This article presents a technique of performing a minimally invasive OW-HTO using a patient-specific cutting guide (PSCG). Preoperative 3-dimensional planning with computed tomography imaging is essential. The correction parameters, the final plate position, as well as the 3-dimensional position of the hinge as well as wedge are verified preoperatively before the PSCG is produced. After exposure with an oblique incision over the posteromedial tibia, the hamstring tendons are released for later re-attachment and the medial collateral ligament is released slightly. The PSCG is then used to perform the OW-HTO with protection of the posterior neurovascular structures by a retractor placed posterior to the medial collateral ligament. The final fixation of the osteotomy is achieved with a low-profile locking plate and a femoral head allograft wedge.

Domaines: Sciences du Vivant [q-bio]

Hamid Rahmatullah Bin Abd Razak, Christophe Jacquet, Adrian J Wilson, Raghbir S Khakha, Kristian Kley, et al.. Minimally Invasive High Tibial Osteotomy Using a Patient-Specific Cutting Guide. Arthroscopy Techniques, 2021, 10, pp.e431 - e435. ⟨10.1016/j.eats.2020.10.029⟩. ⟨hal-03245904⟩