Open-Wedge High Tibial Osteotomy Using a Protective Cutting System: Technical Advancement for the Accuracy of the Osteotomy and Avoiding Intraoperative.

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Open-Wedge High Tibial Osteotomy Using a Protective Cutting System: Technical Advancement for the Accuracy of the Osteotomy and Avoiding Intraoperative Complications Yong Seuk Lee, M.D., Ph.D., Myung Chul Lee, M.D., Ph.D., Seo Goo Kang, M.D., Ashraf Elazab, M.D., Won Seok Oh, M.D. Arthroscopy Techniques Volume 5, Issue 1, Pages e7-e10 (February 2016) DOI: 10.1016/j.eats.2015.08.016 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 (A) The protective cutting system is composed of a releaser and a protective cutting complex. (B) The protective cutting complex is composed of a separate cutting block and a protector. The cutting block has a slot for the saw (single-headed arrow), holes for fixing the cutting block to the anteromedial cortex (line), and a slot for connecting the cutting block to the protector (double-headed arrow). (C) The saw blade is inserted through the slot of the cutting block, and it is directed to the tip of the protector. Arthroscopy Techniques 2016 5, e7-e10DOI: (10.1016/j.eats.2015.08.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A) The releaser is inserted through the released interval, and further release is performed by pushing the releaser with contact at the posterior cortex. (B) If the tip portion of the releaser accesses the fibular head area, the protector is inserted at the interval between the posterior cortex and the releaser, and the releaser is removed. (C) The tip portion of the protector is hooked to the target portion of the hinge that is located at the lateral cortex of the proximal tibia. Arthroscopy Techniques 2016 5, e7-e10DOI: (10.1016/j.eats.2015.08.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 (A) The superior surface of the cutting block is placed parallel to the natural slope (red lines) by controlling the protector's handle. (B) If the cutting slope is acceptable, guide pins are inserted in the holes of the cutting block. (C) Final C-arm image for sawing. Arthroscopy Techniques 2016 5, e7-e10DOI: (10.1016/j.eats.2015.08.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions