Large deformity correction in medial open-wedge high tibial osteotomy may cause degeneration of patellofemoral cartilage: A retrospective study. Issue 5 (February 2019)

• Record Type: Journal Article
• Authors: Otakara, Eigo; Nakagawa, Shuji; Arai, Yuji; Inoue, Hiroaki; Kan, Hiroyuki; Nakayama, Yusuke; Fujii, Yuta; Ueshima, Keiichiro; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Kubo, Toshikazu
• Other Names: Li. Yan section editor.
• Is Part Of: Medicine. Volume 98:Issue 5(2019)
• Publication Date: 2019-02
• Subjects: cartilage degeneration -- high tibial osteotomy -- patellofemoral joint; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000014299
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: To evaluate retrospectively any association between the degree of deformity correction by medial open-wedge high tibial osteotomy (HTO) and patellofemoral joint degeneration. We hypothesized that development of patellofemoral joint degeneration depended on the degree of intraoperative deformity correction. Fifty-seven patients who underwent medial open-wedge HTO for treatment of osteoarthritis in one knee were included in this study. Knees were classified into degeneration (D) and non-degeneration (ND) groups according to worsening of the patellar and/or femoral trochlear cartilage at the time of hardware removal (D group, 27 knees) and no degeneration or improvement (ND group, 30 knees). We compared pre- to post-surgery change in hip-knee-ankle angle (HKA) and medial-proximal-tibial angle (MPTA), open-wedge HTO correction angle, and arthroscopic findings between groups. Mean age, height, weight, and body mass index were 54.1 ± 9.9 years, 160.4 ± 8.7 cm, 66.4 ± 12.1 kg, and 25.7 ± 3.3 kg/m 2, respectively. Change in both HKA and MPTA differed significantly between groups. The MPTA cut-off values to predict patellofemoral degeneration were determined to be 10°, associated with an AUC of 0.75 (95% confidence interval [CI] 0.62–0.87). This study evaluated retrospectively the effect of the correction angle during medial open-wedge HTO on patellofemoral joint degeneration. If deformity correction exceeds an MPTA of 10° during open-wedge HTO, degeneration of patellofemoral joint needs to be considered. Level of evidence: Level IV.