Medial Opening Wedge High Tibial Osteotomy in Knee Osteoarthritis-A Biomechanical Approach

Featured Application This research provides a "mini intraoperative guide" for geometrical and dimensional planning of the medial wedge open high tibial osteotomy. The values obtained in our study are useful for preventing or minimizing the microfractures that can occur in the center of the rotation of the angulation (CORA) hinge area. This paper provides an analysis from a biomechanical perspective of the medial opening wedge high tibial osteotomy surgery, a medical procedure commonly used in treating knee osteoarthritis. The aim of this research is to improve the analysed surgical strategy by establishing optimal values for several very important parameters for the geometric planning of this type of surgical intervention. The research methods used are numerical and experimental. We used finite element, a numerical method used to study the intraoperative behavior of the CORA area for different positions of the initiation point of the cut of the osteotomy plane and for different correction angles. We also used an experimental method in order to determine the maximum force which causes the occurrence of cracks or microcracks in the CORA area. This helped us to determine the stresses, the maximum forces, and the force-displacement variations in the hinge area, elements that allowed us to identify the optimal geometric parameters for planning the surgery.