Evaluation of a Fixed-Angle Wedge Osteotomy GuideFunding No funding was provided for this project. IMEX Veterinary, Inc. manufactured this guide, but they did not influence the content of this article or fund this project.
Objective The aim of this study was to evaluate a fixed-angle cutting guide designed to aid in the performance of coplanar wedge osteotomies using a proximal tibial cranial closing wedge ostectomy model.
Study Design A 30-degree cranial closing wedge ostectomy was created using canine tibia models with either a standard template (method T) or a wedge osteotomy guide (method G) by two surgeons. One surgeon was experienced with both procedures, and one surgeon had no previous experience with the wedge guide. The ostectomy wedges were evaluated for wedge angle, using a digital protractor, and coplanarity by using digital photographs and screen-measuring software.
Results The mean (standard deviation) wedge angles of the T and G groups were 28.16 (1.33) and 28.4 degrees (1.46) respectively. The mean (standard deviation) divergence angles of the T and G groups were 3.21 (1.86) and 2.22 degrees (1.69) respectively. The measured reference angles of the template and cut guides were 31.27 and 29.60 degrees respectively. Individual and cross-surgeon analysis of outcomes found no significant differences when comparing wedge angle or coplanarity with either method regardless of surgeon experience. However, mean wedge angle of group G was significantly closer to the measured reference angles than group T (p < 0.01).
Conclusion Use of a fixed-angle surgical wedge guide was successful in consistently producing accurate closing wedge ostectomies regardless of surgeon experience. These results show that use of the guide is a valid method for performing wedge ostectomies.
K.N. was responsible for data acquisition. S.F. was responsible for study coordination and materials acquisition. M.C. performed osteotomy procedures for this project. A.C. was responsible for study design and implementation and performed osteotomy procedures for this project. All authors contributed to creation of the manuscript.
Received: 18 December 2019
Accepted: 21 July 2020
24 September 2020 (online)
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Slocum B, Devine T. Cranial tibial wedge osteotomy: a technique for eliminating cranial tibial thrust in cranial cruciate ligament repair. J Am Vet Med Assoc 1984; 184 (05) 564-569
- 2 Talaat MB, Kowaleski MP, Boudrieau RJ. Combination tibial plateau leveling osteotomy and cranial closing wedge osteotomy of the tibia for the treatment of cranial cruciate ligament-deficient stifles with excessive tibial plateau angle. Vet Surg 2006; 35 (08) 729-739
- 3 Balfour RJ, Boudrieau RJ, Gores BR. T-plate fixation of distal radial closing wedge osteotomies for treatment of angular limb deformities in 18 dogs. Vet Surg 2000; 29 (03) 207-217
- 4 Brower BE, Kowaleski MP, Peruski AM. et al. Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs. Vet Comp Orthop Traumatol 2017; 30 (01) 20-27
- 5 Addison ES, Emmerson TD, de la Puerta B. et al. Evaluation of osteotomy accuracy and rotational and angular alignment for cranial closing wedge ostectomy performed with and without alignment aids. Vet Surg 2015; 44 (01) 78-84
- 6 Heijink A, Gomoll AH, Madry H. et al. Biomechanical considerations in the pathogenesis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 2012; 20 (03) 423-435
- 7 Panula HE, Helminen HJ, Kiviranta I. Slowly progressive osteoarthritis after tibial valgus osteotomy in young beagle dogs. Clin Orthop Relat Res 1997; (343) 192-202
- 8 Claes L, Augat P, Suger G, Wilke HJ. Influence of size and stability of the osteotomy gap on the success of fracture healing. J Orthop Res 1997; 15 (04) 577-584
- 9 Shi J, Lv W, Wang Y. et al. Three dimensional patient-specific printed cutting guides for closing-wedge distal femoral osteotomy. Int Orthop 2019; 43 (03) 619-624
- 10 Olimpo M, Piras LA, Peirone B, Fox DB. Comparison of osteotomy technique and jig type in completion of distal femoral osteotomies for correction of medial patellar luxation. An in vitro study. Vet Comp Orthop Traumatol 2017; 30 (01) 28-36
- 11 Tan CJ, Bergh MS, Schembri MA, Johnson KA. Accuracy of tibial osteotomy placement using 2 different tibial plateau leveling osteotomy jigs. Vet Surg 2014; 43 (05) 525-533
- 12 Marcellin-Little DJ, Harrysson OL, Cansizoglu O. In vitro evaluation of a custom cutting jig and custom plate for canine tibial plateau leveling. Am J Vet Res 2008; 69 (07) 961-966
- 13 Munier M, Donnez M, Ollivier M. et al. Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? Pilot study. Orthop Traumatol Surg Res 2017; 103 (02) 245-250
- 14 Sys G, Eykens H, Lenaerts G, Shumelinsky F, Robbrecht C, Poffyn B. Accuracy assessment of surgical planning and three-dimensional-printed patient-specific guides for orthopaedic osteotomies. Proc Inst Mech Eng H 2017; 231 (06) 499-508
- 15 Shamir SK, Wolynski JG, Duncan CG, Puttlitz C, Duerr FM. Ex vivo evaluation of a novel surgical guide on the accuracy of closing wedge osteotomies. Vet Surg 2019; 48 (08) 1429-1436
- 16 Wang G, Zheng G, Keppler P. et al. Implementation, accuracy evaluation, and preliminary clinical trial of a CT-free navigation system for high tibial opening wedge osteotomy. Comput Aided Surg 2005; 10 (02) 73-85
- 17 Duerr FM, Duncan CG, Savicky RS, Park RD, Egger EL, Palmer RH. Comparison of surgical treatment options for cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle. Vet Surg 2008; 37 (01) 49-62