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An analysis of the results of 121 minus-valgizing osteotomies in genu varum performed in the years 1985-1998 allowed the authors to conclude that the recommended by most researchers hyper-corrective valgus positioning of the knee's mechanical axis after an osteotomy resulted in increased postoperative valgity in 12 cases. This complication nullified the intended effect of the operation and required another corrective procedure. Clinical observations showed that the probable causes of the complications could be different, e.g. a significant decrease of bone density in the joint's exterior section, taking over the body-weight load, and the patient's considerable overweight. Whereas the presumptive cause was a limited capability of remodelling of the overloaded exterior section of the joint. In order to determine the magnitude and distribution of static forces in the knee's articular ends, a series of measurements were made using spatial photoelastic models as exact geometrical copies of specimens from autopsy. The measurements have shown that in the case of the hypercorrective position of the joint's axis, an extremely heavy concentration of forces occurs on the relatively small bearing surface of the outer condyle of the tibia. This creates adverse mechanical conditions and makes it impossible to obtain the intended correction angle.
Czasopismo
Rocznik
Tom
Strony
31--40
Opis fizyczny
Bibliogr. 33 poz., rys., wykr.
Twórcy
autor
- Specialistic Rehabilitative-Orthopaedic Health Care Centre, Orthopaedic Department, Wrocław
autor
autor
Bibliografia
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- [23] LEKSZYCKI T., SLAWINSKI A., Osteoporosis effect in the adaptation of bone structure, Acta of Bioengineering and Biomechanics, 1999, Vol. 1, Suppl. 1, pp. 285-288.
- [24] AKAMATSU Y., KOSHINO T., SAITO T., WADA J., Changes in osteosclerosis of the osteoarthritic knee after high tibial osteotomy, Clin. Orthop., 1997,334 (1), 207-214.
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- [26] GORECKI A., SOBCZYK T., KOWALSKI M., The effect of high tibial osteotomy in osteoarthritis of the knee joint on tibia mineralization (in Polish), Chir. Narz. Ruchu Ortop. Pol., 1996,61 (supl.), 199-202.
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- [28] TAKAHASHI S., Changes of the subchondral osteosclerosis in )he femoral and tibial condyles during long-term after high tibial osteotomy for medial compartmental osteoartritis of the knee, Nippon Seikeigeka Gakkai Zasshi, 1993, 67, 5, 417-426.
- [29] Hsu R.H., AIMENO S., COUENTRY M.B., CHAO E.Y.S., Normal axial alignment of the lower extremity and load bearing distribution of the knee, Clin. Orthop., 1990, 255, 215-227.
- [30] MAQUET P.G.J., PELZER G.A., Evolution of the maximum stress in osteoarthritis the knee. J. Biomech., 1977, 10 (2), 107-117.
- [31] WALKER P.S., HAJEK J.V., The load-bearing area in the knee joint, J. Biomech., 1972,5,581-589.
- [32] BĘDZIŃSKI R., POZOWSKI A., ŚCIGAŁA K., The experimental study of dislocations in the region of the knee joint (in polish), Biomechanika, 1995, (73), Zeszyty Naukowe, Materiały Ogólnopolskiej Konferencji Naukowej, Krakow, 1995, 14-19.
- [33] POZOWSKI A., BĘDZIŃSKI R., ŚCIGAŁA K., Experimental verification of bone dislocation and bone tensions in the ends of bones in varus knee joint and after osteotomy (in polish), Chir. Narz. Ruchu Ortop. Pol. (supl. 3B) 1996, t. 61, 147-156.
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-article-BPB1-0014-0003