Posteromedial Open-Wedge High Tibial Osteotomy to Avoid Posterior Tibial Slope Increase.


Kaya H. , Daştan A., Kaya B. , Taşkiran E.

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol.36, pp.2710-2717, 2020 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 36
  • Publication Date: 2020
  • Doi Number: 10.1016/j.arthro.2020.06.024
  • Title of Journal : Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
  • Page Numbers: pp.2710-2717

Abstract

Purpose: The primary aim was to evaluate the influence of the surgical modification on posterior tibial slope (PTS) and patellar height in open-wedge high tibial osteotomy (OWHTO). The secondary aim was to evaluate the influence of preoperative mechanical axis deviations (MA) on PTS Methods: Between January 2014 and February 2016, patients with a diagnosis of medial-compartment osteoarthritis who had undergone OWHTO with posteromedial osteotomy technique with a minimum follow-up of 3 months were included in this retrospective study. Preoperative and postoperative PTS angles with 3 different methods and patellar heights with respect to the InsalleSalvati and CatoneDeschamps indices were measured on lateral radiographs by 2 observers. Patients were grouped according to preoperative MA (either <10 degrees or >= 10 degrees). PTS changes were compared between groups Results: Thirty consecutive knees of 28 patients were evaluated. Preoperative mean PTS angles were 9.50 degrees +/- 4.47 degrees (posterior tibial cortex referenced), 11.51 degrees +/- 4.50 degrees (tibial anatomical axis referenced), and 10.80 degrees +/- 4.58 degrees (posterior fibular cortex referenced); postoperative angles were 6.10 degrees +/- 4.23 degrees, 8.78 degrees +/- 4.57 degrees, and 8.11 degrees +/- 4.55 degrees, respectively. PTS was significantly decreased postoperatively with respect to all 3 methods (P <.0001). Mean preoperative and postoperative InsalleSalvati indices were 1.04 +/- 0.16 and 1.07 +/- 0.17, respectively (P 1/4 .088). Mean preoperative and postoperative CatoneDeschamps indices were 0.87 +/- 0.18 and 0.78 +/- 0.18, respectively (P = .017). PTS changes were not statistically significant between groups with respect to MA (P values.861,.723, and.727, respectively) Conclusions: