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Ex vivo evaluation of a novel surgical guide on the accuracy of closing wedge osteotomies
Author(s) -
Shamir Shelly K.,
Wolynski Jakob G.,
Duncan Colleen G.,
Puttlitz Christian,
Duerr Felix M.
Publication year - 2019
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13237
Subject(s) - medicine , osteotomy , wedge (geometry) , ex vivo , fixation (population genetics) , orthodontics , surgery , population , nuclear medicine , in vivo , mathematics , geometry , microbiology and biotechnology , environmental health , biology
Objective To determine the influence of a novel surgical guide on the accuracy and technical difficulty of closing wedge osteotomies (CWO). Study design Ex vivo experimental study. Sample population Canine tibia models (n = 40). Methods A 20° cranial CWO (CCWO) was created without (standard procedure; STCCWO) or with the aid of a novel wedge osteotomy guide (WOCCWO). Procedures were performed by diplomate (n = 4) and resident (n = 6) surgeons, with each performing 2 STCCWO followed by 2 WOCCWO. To prevent bias, surgeons were unaware of the study purpose until after completing the STCCWO. The wedges were evaluated by comparing the deviation from the 20° target angle, divergence of the 2 osteotomies (osteotomy divergence angle [ODA]), and measurements of the wedge height at the caudomedial cortex (CMC) and caudolateral cortex (CLC). Technique difficulty was explored through a surgeon questionnaire. Results The WOCCWO resulted in smaller mean ODA (WOCCWO = 0.86°, SD ± 0.38°, P < .001), and smaller mean difference between CMC and CLC (WOCCWO = 0.29 mm, SD ± 0.19, P < .001) than for the STCCWO (4.22°, SD ± 2.16° and 1.39 mm, SD ± 0.65 respectively). Deviation from the target 20° wedge angle was greater after STCCWO (1.46°, SD ± 1.27°) than after WOCCWO (0.53°, SD ± 0.33°, P = .004). No difference was reported regarding the difficulty of the procedures, but resident surgeons stated that they were more likely to use the guide in a clinical setting compared with diplomates. Conclusion The wedge osteotomy guide improved the accuracy of CCWO compared with standard technique. Clinical significance The clinical significance of the differences detected in this study is unclear and warrants in vivo investigation.