{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T19:37:40Z","timestamp":1773603460319,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,2,1]],"date-time":"2012-02-01T00:00:00Z","timestamp":1328054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Biplanar open\u2010wedge high tibial osteotomy (HTO) is thought to promote rapid bone healing due to the increased cancellous bone surface compared to other HTO techniques. However, precise data on the bone surface area and wedge volume resulting from both open\u2010 and closed\u2010wedge HTO techniques remain unknown. We hypothesized that biplanar rather than uniplanar HTO better reflects the ideal geometrical requirements for bone healing, representing a large cancellous bone surface combined with a small wedge volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Tibial saw bones were assigned to 4 different groups of valgisation high tibial osteotomies: group 1: open\u2010wedge uniplanar HTO; group 2: open\u2010wedge biplanar HTO with ascending frontal cut; group 3: open\u2010wedge biplanar HTO with descending frontal cut (retrotubercule osteotomy technique), and group 4: closed\u2010wedge uniplanar HTO. Bone surface areas of all osteotomy planes were quantified. Wedge volumes were determined using a prism\u2010based algorithm, applying standardized wedge heights of 5, 10, and 15\u00a0mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The open\u2010wedge biplanar osteotomy with a descending frontal cut (group 3) created significantly larger bone surfaces compared to the \u201cclassic\u201d biplanar technique with an ascending frontal cut (group 2) and compared to all uniplanar techniques. Bone surfaces after the classic open\u2010wedge technique (group 2) were slightly larger compared to all uniplanar techniques (group 1 and 4). No significant differences of wedge volumes were found between the retrotubercle (group 3) and classic open\u2010wedge techniques (group 2). Wedge volumes were significantly higher in the uniplanar open\u2010wedge technique (group 1) compared to the biplanar open\u2010wedge techniques (group 2 and 3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bone geometry following HTO suggests that the biplanar open\u2010wedge techniques simultaneously create smaller wedge volumes and larger bone surface areas compared to the uniplanar open\u2010wedge techniques. The relatively neglected closed\u2010wedge technique still offers in theory the best healing potential, characterized by an almost absent wedge volume and a large bone\u2010to\u2010bone contact area. Although this idealized geometric view on bony geometry excludes all biologic factors that influence bone healing, the current data suggest a general rule for the applied standard osteotomy techniques and all of their surgical modifications: reducing the amount of slow gap healing and simultaneously increasing the area of faster contact healing may be beneficial for osteotomy healing. Thus, a biplanar rather than a uniplanar osteotomy may be performed for high tibial osteotomy in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-1913-x","type":"journal-article","created":{"date-parts":[[2012,1,31]],"date-time":"2012-01-31T01:40:19Z","timestamp":1327974019000},"page":"127-133","source":"Crossref","is-referenced-by-count":40,"title":["Wedge volume and osteotomy surface depend on surgical technique for high tibial osteotomy"],"prefix":"10.1002","volume":"21","author":[{"given":"Dietrich","family":"Pape","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Clinique d\u2019Eich Centre Hospitalier de Luxembourg 78, rue d\u2019Eich 1460 Luxembourg Luxembourg"},{"name":"<!--<label>3<\/label>--> Sports Medicine Research Laboratory, Public Research Centre for Health, Luxembourg Centre M\u00e9dical de la Fondation Norbert Metz 76 rue d\u2019Eich 1460 Luxembourg Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Dueck","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Clinique d\u2019Eich Centre Hospitalier de Luxembourg 78, rue d\u2019Eich 1460 Luxembourg Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Haag","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Clinique d\u2019Eich Centre Hospitalier de Luxembourg 78, rue d\u2019Eich 1460 Luxembourg Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaf","family":"Lorbach","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Saarland University 66421 Homburg Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romain","family":"Seil","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Clinique d\u2019Eich Centre Hospitalier de Luxembourg 78, rue d\u2019Eich 1460 Luxembourg Luxembourg"},{"name":"<!--<label>3<\/label>--> Sports Medicine Research Laboratory, Public Research Centre for Health, Luxembourg Centre M\u00e9dical de la Fondation Norbert Metz 76 rue d\u2019Eich 1460 Luxembourg Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henning","family":"Madry","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Saarland University 66421 Homburg Saar Germany"},{"name":"<!--<label>4<\/label>--> Experimental Orthopaedics and Osteoarthritis Research Saarland University Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,2]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010009\u20100889\u20108"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0883\u20105403(89)80002\u20106"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198110000-00018"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1060\u20101872(00)80022\u20102"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2004.02.002"},{"key":"e_1_2_7_7_2","doi-asserted-by":"crossref","unstructured":"HanSB LeeDH ShettyGM ChaeDJ SongJG NhaKWA \u201csafe zone\u201d in medial open\u2010wedge high tibia osteotomy to prevent lateral cortex fracture.Knee Surg Sports Traumatol Arthrosc(2011)","DOI":"10.1007\/s00167-011-1706-7"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199110000-00029"},{"key":"e_1_2_7_9_2","doi-asserted-by":"crossref","unstructured":"IorioR PagnottelliM VadalaA GiannettiS DiSP PapandreaP ConteducaF FerrettiAOpen\u2010wedge high tibial osteotomy: comparison between manual and computer\u2010assisted techniques.Knee Surg Sports Traumatol Arthrosc(2011)22113220","DOI":"10.1007\/s00167-011-1785-5"},{"key":"e_1_2_7_10_2","first-page":"55","volume-title":"Osteotomies around the knee. 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