Preoperative planning for lower extremity osteotomies: an analysis using 4 different methods and 3 different...

Area of Science:

• Orthopedic surgery
• Biomechanical analysis
• Surgical planning

Background:

• Lower extremity osteotomy is a standard surgical procedure for correcting deformities and treating unicompartmental gonarthrosis.
• The impact of osteotomy on lower extremity length is often overlooked in surgical considerations.
• Accurate leg length assessment is crucial for functional outcomes and patient satisfaction post-surgery.

Purpose of the Study:

• To numerically analyze the apparent leg length changes before and after osteotomy surgery.
• To compare the effects of different osteotomy techniques (closing wedge, opening wedge, dome) on leg length.
• To evaluate the influence of various preoperative planning and intraoperative methods on leg length outcomes.

Main Methods:

• Numerical analysis of leg length changes associated with osteotomy.
• Comparison of three major lower extremity osteotomy types: closing wedge, opening wedge, and dome osteotomies.
• Evaluation of four distinct planning techniques: three preoperative and one intraoperative method.

Main Results:

• Preoperative planning variations with a single osteotomy technique yielded leg length changes ranging from 0.5 to 3 mm.
• Differences in lower extremity alignment exceeding 7 degrees were observed based on the planning method used.
• Comparing different osteotomy techniques indicated a potential leg length difference of up to 2 cm.

Conclusions:

• Surgical planning methods significantly influence leg length outcomes in lower extremity osteotomies.
• The choice of osteotomy technique can lead to substantial variations in leg length.
• Further investigation into optimizing planning and surgical techniques is warranted to minimize leg length discrepancies.