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

Autor:	Kaya H; Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir, Turkey. Electronic address: hkaya45@hotmail.com., Dastan AE; Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir, Turkey., Bicer EK; Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir, Turkey., Taskiran E; Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir, Turkey.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2020 Oct; Vol. 36 (10), pp. 2710-2717. Date of Electronic Publication: 2020 Jul 04.
DOI:	10.1016/j.arthro.2020.06.024
Abstrakt:	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 Insall-Salvati and Caton-Deschamps indices were measured on lateral radiographs by 2 observers. Patients were grouped according to preoperative MA (either <10° or ≥10°). PTS changes were compared between groups RESULTS: Thirty consecutive knees of 28 patients were evaluated. Preoperative mean PTS angles were 9.50° ± 4.47° (posterior tibial cortex referenced), 11.51° ± 4.50° (tibial anatomical axis referenced), and 10.80° ± 4.58° (posterior fibular cortex referenced); postoperative angles were 6.10° ± 4.23°, 8.78° ± 4.57°, and 8.11° ± 4.55°, respectively. PTS was significantly decreased postoperatively with respect to all 3 methods (P < .0001). Mean preoperative and postoperative Insall-Salvati indices were 1.04 ± 0.16 and 1.07 ± 0.17, respectively (P = .088). Mean preoperative and postoperative Caton-Deschamps 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: It is possible to preserve and even decrease PTS with an OWHTO performed posterior to MCL in a posteromedial to anterolateral direction. Level of Evidence: Level IV, retrospective case series. (Copyright © 2020 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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