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High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height

OBJECTIVE: To compare the clinical outcomes of performing a closed tibial high osteotomy with an open osteotomy and the changes in posterior tibia slope and patellar height. METHODS: Methods were collected from three hundred and forty patients (440 knees) with high tibial osteotomy performed from Ja...

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Autores principales: Ji, Songjie, Gao, Yuan, Zhang, Jun, Pan, Feng, Zhu, Kunzhi, Jiang, Xu, Zhou, Yixin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536261/
https://www.ncbi.nlm.nih.gov/pubmed/37780911
http://dx.doi.org/10.3389/fsurg.2023.1219614
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author Ji, Songjie
Gao, Yuan
Zhang, Jun
Pan, Feng
Zhu, Kunzhi
Jiang, Xu
Zhou, Yixin
author_facet Ji, Songjie
Gao, Yuan
Zhang, Jun
Pan, Feng
Zhu, Kunzhi
Jiang, Xu
Zhou, Yixin
author_sort Ji, Songjie
collection PubMed
description OBJECTIVE: To compare the clinical outcomes of performing a closed tibial high osteotomy with an open osteotomy and the changes in posterior tibia slope and patellar height. METHODS: Methods were collected from three hundred and forty patients (440 knees) with high tibial osteotomy performed from January 2019 to January 2020. Forty patients (50 knees) had a lateral closed wedge tibial osteotomy (LCWHTO), and 300 patients (390 knees) had a medial open wedge tibial osteotomy (MOWHTO). The follow-up periods were 20.5 months and 19.9 months, respectively. At the final follow-up visit, both groups evaluated the Lysholm score and joint range of motion (ROM). Changes in preoperative and postoperative mechanical axis deviation (MAD), proximal medial tibial angle (MPTA), posterior tibial slope (PTS), and M-K index were compared between the two groups of patients. RESULTS: Lysholm scores were 79.6 ± 15.6 preoperatively and 96.0 ± 5.0 postoperatively in the LCWHTO group (p < 0.01); 83.7 ± 16.0 preoperatively and 94.3 ± 9.1 postoperatively in the MOWHTO group (p < 0.01). ROM was 136.0° ± 8.4° preoperatively and 133.2° ± 10.1° postoperatively in the LCWHTO group (p > 0.05); 136.5° ± 8.4° preoperatively and 135.7° ± 9.3° postoperatively in the MOWHTO group (p > 0.05). the MAD was (26.5 ± 4.1) mm preoperatively and 0.3 ± 2.9 mm postoperatively in the LCWHTO group (p < 0.01); 21.8 ± 6.5 mm preoperatively and −0.3 ± 2.6 mm postoperatively in the MOWHTO group (p < 0.01). The MPTA in the LCWHTO group was 75.3° ± 3.2° preoperatively and 89.5° ± 2.4° postoperatively (p < 0.01). 77.1° ± 3.0° preoperatively and 90.6° ± 2.7° postoperatively in the MOWHTO group (p < 0.01). M-K index was 0.78 ± 0.08 preoperatively and 0.79 ± 0.07 postoperatively in the LCWHTO group (p > 0.05). 0.78 ± 0.05 before and 0.75 ± 0.05 after surgery in the MOWHTO. 10.8° ± 3.0° PTS before and 8.1° ± 3.4° after surgery in the LCWHTO group (p < 0.05); 10.2° ± 3.1° preoperatively and 10.9° ± 4.0° postoperatively (p > 0.05). CONCLUSIONS: LCWHTO decreases the PTS and has no effect on patellar height; MOWHTO does not affect the PTS but decreases patellar height. The patient should individualize the choice of the osteotomy.
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spelling pubmed-105362612023-09-29 High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height Ji, Songjie Gao, Yuan Zhang, Jun Pan, Feng Zhu, Kunzhi Jiang, Xu Zhou, Yixin Front Surg Surgery OBJECTIVE: To compare the clinical outcomes of performing a closed tibial high osteotomy with an open osteotomy and the changes in posterior tibia slope and patellar height. METHODS: Methods were collected from three hundred and forty patients (440 knees) with high tibial osteotomy performed from January 2019 to January 2020. Forty patients (50 knees) had a lateral closed wedge tibial osteotomy (LCWHTO), and 300 patients (390 knees) had a medial open wedge tibial osteotomy (MOWHTO). The follow-up periods were 20.5 months and 19.9 months, respectively. At the final follow-up visit, both groups evaluated the Lysholm score and joint range of motion (ROM). Changes in preoperative and postoperative mechanical axis deviation (MAD), proximal medial tibial angle (MPTA), posterior tibial slope (PTS), and M-K index were compared between the two groups of patients. RESULTS: Lysholm scores were 79.6 ± 15.6 preoperatively and 96.0 ± 5.0 postoperatively in the LCWHTO group (p < 0.01); 83.7 ± 16.0 preoperatively and 94.3 ± 9.1 postoperatively in the MOWHTO group (p < 0.01). ROM was 136.0° ± 8.4° preoperatively and 133.2° ± 10.1° postoperatively in the LCWHTO group (p > 0.05); 136.5° ± 8.4° preoperatively and 135.7° ± 9.3° postoperatively in the MOWHTO group (p > 0.05). the MAD was (26.5 ± 4.1) mm preoperatively and 0.3 ± 2.9 mm postoperatively in the LCWHTO group (p < 0.01); 21.8 ± 6.5 mm preoperatively and −0.3 ± 2.6 mm postoperatively in the MOWHTO group (p < 0.01). The MPTA in the LCWHTO group was 75.3° ± 3.2° preoperatively and 89.5° ± 2.4° postoperatively (p < 0.01). 77.1° ± 3.0° preoperatively and 90.6° ± 2.7° postoperatively in the MOWHTO group (p < 0.01). M-K index was 0.78 ± 0.08 preoperatively and 0.79 ± 0.07 postoperatively in the LCWHTO group (p > 0.05). 0.78 ± 0.05 before and 0.75 ± 0.05 after surgery in the MOWHTO. 10.8° ± 3.0° PTS before and 8.1° ± 3.4° after surgery in the LCWHTO group (p < 0.05); 10.2° ± 3.1° preoperatively and 10.9° ± 4.0° postoperatively (p > 0.05). CONCLUSIONS: LCWHTO decreases the PTS and has no effect on patellar height; MOWHTO does not affect the PTS but decreases patellar height. The patient should individualize the choice of the osteotomy. Frontiers Media S.A. 2023-09-12 /pmc/articles/PMC10536261/ /pubmed/37780911 http://dx.doi.org/10.3389/fsurg.2023.1219614 Text en © 2023 Ji, Gao, Zhang, Pan, Zhu, Jiang and Zhou. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Ji, Songjie
Gao, Yuan
Zhang, Jun
Pan, Feng
Zhu, Kunzhi
Jiang, Xu
Zhou, Yixin
High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height
title High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height
title_full High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height
title_fullStr High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height
title_full_unstemmed High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height
title_short High tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height
title_sort high tibial lateral closing wedge and opening wedge valgus osteotomy produce different effects on posterior tibial slope and patellar height
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536261/
https://www.ncbi.nlm.nih.gov/pubmed/37780911
http://dx.doi.org/10.3389/fsurg.2023.1219614
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