Sagittal and coronal plane location of the popliteal artery in the open-wedge high tibial osteotomy.

Purpose: The objectives of this study were (1) to evaluate the sagittal and coronal plane location of the popliteal artery during the advancement of open-wedge high tibial osteotomy and (2) to confirm the effect of osteoarthritis if it changes the relationship between the popliteal artery and posterior cortex.

Methods: Two hundred consecutive patients were enrolled, and we divided patients into two subgroups according to age and cartilage status in the radiologic report of magnetic resonance imaging (group I: 100 non-arthritic knees; group II: 100 arthritic knees). For prediction of the location of the popliteal artery during the operation, sagittal and coronal plane location along the osteotomy plane was evaluated.

Results: The distance between the posterior cortex of the osteotomy and popliteal artery was 13-14 mm on the sagittal plane, and the popliteal artery was located at an approximately 35 ± 5.5 mm portion from the starting point of the osteotomy on the coronal plane. The distance at the starting point of osteotomy was larger than at the end portion and prominent area. In comparison between groups I and II, group II showed a larger distance on the sagittal planes [osteotomy-vascular: 13.6 vs 14.4 (p = 0.01), fibula-vascular: 4.88 vs 6.5 (p < 0.01), and prominence-vascular: 4.3 vs 5.3 (p < 0.01)] compared to the group I.

Conclusions: Special caution and some protection should be given until the approximately 35 mm portion from the starting point of the posteromedial cortex with consideration for the approximity on the sagittal plane. In comparison between the non-arthritic and arthritic knee, differences were observed on the sagittal plane. However, the value was minimal, and the clinical relevance was questionable.

Level Of Evidence: Case series, Level IV.