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Erschienen in:
01.09.2015 | Original Article
Tibial slope and patellar height changes following high tibial osteotomy (a comparative study)
Erschienen in: European Orthopaedics and Traumatology | Ausgabe 3/2015
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Background
Improving the accuracy of high tibial osteotomy not only in the coronal plane but with considering it as a three dimension procedure can give better long term results in cases of medial compartment osteoarthritis associated with varus deformity and minimize the obstacles faced in future total knee replacement (TKR).
Design
Two different techniques of high tibial osteotomy: the opening wedge (OWO) and the hemicallotasis osteotomy (HCO) were compared clinically in a prospective randomized clinical trial that was held in Ain Shams University hospitals in the period from December 2010 to April 2013 on thirty knees of twenty-four patients suffering from medial compartment osteoarthritis associated with varus deformity. The patients were allocated randomly (single-blinded) in two groups; where fifteen knees of group (I) underwent high tibial osteotomy using the OWO technique, while those of group (II) underwent the procedure using the HCO technique. Two important parameters were compared; the posterior tibial slope in lateral radiographs using the anatomical proximal tibial axis and the patellar height using the Caton&Deschamps method; to assess the accuracy of the procedure in the sagittal plane.
Results
OWO had proven lower accuracy than HCO as regard the change in tibial slope (P = 0.001 and 0.3 respectively), while both techniques preserved patellar height almost unchanged with optimizing the procedures’ techniques (P = 0.4 and 0.6 respectively).
Conclusion
HCO technique for osteoarthritic knees associated with varus deformity can give more accurate results for the sagittal limb alignment and this may improve the long term results of the procedure and facilitate future TKR.