Proximal tibiofibular joint pain versus peroneal nerve dysfunction: clinical results of closed-wedge high tibial osteotomy performed with proximal tibiofibular joint disruption

Özcan, Özal; Eroglu, Mehmet; Boya, Hakan; Kaya, Yılmaz

doi:10.1007/s00167-016-4066-5

Cited by 7 publications

(9 citation statements)

References 22 publications

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“…The original goal of HTO was to correct deformities of the coronal plane, but unexpected events, the changes in the PTS, occurring in the sagittal position are always inevitable [53, 54]. Our results showed that PTS increases after OWHTO ( p < 0.05) and decreases ( p > 0.05) after CWHTO, which is consistent with several comparative studies [16, 18, 23, 24, 26].…”

Section: Discussionsupporting

confidence: 91%

Radiographic changes and clinical outcomes after open and closed wedge high tibial osteotomy: a systematic review and meta-analysis

et al. 2019

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Background The purpose of this meta-analysis is to examine changes in radiological variables and clinical outcomes between open and closed wedge high tibial osteotomy (OWHTO and CWHTO, respectively), which have ongoing controversial issues in numerous quantitative clinical studies. Methods PubMed, Embase, and the Cochrane Library were systematically searched for suitable controlled trials between Jan 1, 1999, and Feb 2, 2018. The inclusion criteria included studies written in English, studies with a level of evidence of I–IV, and studies presenting comparisons between OWHTO and CWHTO. The main clinical and radiographic results were extracted and pooled using Stata 12.0. Results After searching for and screening trials, 28 trials involving 2840 knees were eligible for the meta-analysis. After OWHTO or CWHTO, clinical scores, including the American Knee Society Score, Hospital for Special Surgery Knee Score, Lysholm score, and Visual Analog Scale pain score, improved ( p < 0.05), but the range of motion was unchanged ( p > 0.05). The anatomical femorotibial angle (SMD 0.04, 95% CI − 0.66 to 0.74) and hip-knee-ankle angle (SMD 0.11, 95% CI − 0.11 to 0.33) data suggested that the OWHTO and CWHTO groups were similar in function of correction. Posterior tibial slope increased (SMD − 0.71, 95% CI − 1.04 to − 0.37) after OWHTO but decreased (SMD 0.72, 95% CI 0.35 to 1.08) after CWHTO. OWHTO decreased patellar height ( p < 0.05), while patellar height did not change significantly after CWHTO ( p > 0.05). Conclusion This meta-analysis indicates that compared with CWHTO, OWHTO increases the posterior slope, decreases the patellar height, and provides a similar accuracy of correction; however, CWHTO leads to a decreased posterior slope and an unchanged patellar height. Therefore, programs should be personalized and customized for the specific situation of each patient.

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Section: Discussionsupporting

confidence: 91%

Radiographic changes and clinical outcomes after open and closed wedge high tibial osteotomy: a systematic review and meta-analysis

et al. 2019

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“…Emerging clinical and epidemiological evidence suggests proximal tibiofibular osteoarthritis may represent an underappreciated cause of posterior and lateral knee pain [8] . For example, patients with presumed peroneal nerve dysfunction have been later found to suffer from tibiofibular articular pathology [10] . While patients with proximal tibiofemoral osteoarthritis classically present with lateral knee pain, studies have correlated posterior knee pain with imaging consistent with the disease [11] .…”

Section: Discussionmentioning

confidence: 99%

Proximal tibiofibular osteoarthritis presenting as pain after total knee arthroplasty treated successfully with fusion of the proximal tibial-fibular joint

2018

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Total knee arthroplasty (TKA) is a common treatment option for end-stage osteoarthritis of the tibiofemoral and patellafemoral joints. Diagnosis and treatment of the painful TKA can pose a significant challenge. In this report, we present the unusual case of a patient 12 years after total knee replacement presenting with isolated proximal tibial-fibular osteoarthritis as a cause of lateral knee pain. Proximal tibiofibular osteoarthritis is not typically on the differential diagnosis for a painful TKA but can be a rare cause of lateral knee pain. Proximal tibiofibular fusion may provide relief of pain and restoration of function.

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“…One of the major perioperative complications after fibular head osteotomy (FHO) is peroneal nerve disfunction. The reported incidence of symptomatic injury stands at between 3-20% [8]. On the other hand, since lateral collateral ligament (LCL) and popliteus-fibular ligament (PFL) originate on the fibular head, TFJD may lead to fibular head rise and a shift in ligament tensioning with a potential impact on lateral knee laxity [9].…”

Section: Introductionmentioning

confidence: 99%

Proximal Tibiofibular Dislocation in Closing-Wedge High Tibial Osteotomy Increases the Risk of Medium and Long-Term Total Knee Replacement

Sánchez-Soler

Coelho

Torres-Claramunt

et al. 2021

JCM

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Proximal tibiofibular dislocation in closing-wedge high tibial osteotomy increases the risk of medium and long-term total knee replacement. Background: High tibial osteotomy is an effective treatment for medial osteoarthritis in young patients with varus knee. The lateral closing-wedge high tibial osteotomy (CWHTO) may be managed with tibiofibular dislocation (TFJD) or a fibular head osteotomy (FHO). TFJD may lead to lateral knee instability and thereby affect mid- and long-term outcomes. It also brings the osteotomy survival rate down. Objective: To compare the CWHTO survival rate in function of tibiofibular joint management with TFJD or FHO, and to determine whether medium and long-term clinical outcomes are different between the two procedures. Material & Methods: A retrospective cohort study was carried out that included CWHTO performed between January 2005 to December 2018. Those patients were placed in either group 1 (FHO) or Group 2 (TFJD). Full-leg weight-bearing radiographs were studied preoperatively, one year after surgery and at final follow-up to assess the femorotibial angle (FTA). The Rosenberg view was used to assess the Ahlbäck grade. The Knee Society Score (KSS) was used to assess clinical outcomes and a Likert scale for patient satisfaction. The total knee replacement (TKR) was considered the end of the follow-up and the point was to analyze the CWHTO survival rate. A sub-analysis of both cohorts was performed in patients who had not been FTA overcorrected after surgery (postoperative FTA ≤ 180°, continuous loading in varus). Results: A total of 230 knees were analyzed. The follow-up period ranged from 24–180 months. Group 1 (FHO) consisted of 105 knees and group 2 (TFJD) had 125. No preoperative differences were observed in terms of age, gender, the KSS, FTA or the Ahlbäck scale; neither were there any differences relative to postop complications. The final follow-up FTA was 178.7° (SD 4.9) in group 1 and 179.5° (SD 4.2) in group 2 (p = 0.11). The Ahlbäck was 2.21 (SD 0.5) in group 1 and 2.55 (SD 0.5) in group 2 (p = 0.02) at the final follow-up. The final KSS knee values were similar for group 1 (86.5 ± 15.9) and group 2 (84.3 ± 15.8). Although a non-significant trend of decreased HTO survival in the TFJD group was found (p = 0.06) in the sub-analysis of non-overcorrected knees, which consisted of 52 patients from group 1 (FHO) and 58 from group 2 (TFJD), 12.8% of the patients required TKR with a mean of 88.8 months in group 1 compared to 26.8% with a mean of 54.9 months in the case of group 2 (p = 0.005). However, there were no differences in clinical and radiological outcomes. Conclusion: TFJD associated with CWHTO shows an increase in the conversion to TKR at medium and long-term follow-up with lower osteotomy survival than the CWHTO associated with FHO, especially in patients with a postoperative FTA ≤ 180° (non-overcorrected). There were no differences in clinical, radiological or satisfaction results in patients who did not require TKR. Level of evidence III. Retrospective cohort study.

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Proximal tibiofibular joint pain versus peroneal nerve dysfunction: clinical results of closed-wedge high tibial osteotomy performed with proximal tibiofibular joint disruption

Abstract: III.

Cited by 7 publications

References 22 publications

Radiographic changes and clinical outcomes after open and closed wedge high tibial osteotomy: a systematic review and meta-analysis

Radiographic changes and clinical outcomes after open and closed wedge high tibial osteotomy: a systematic review and meta-analysis

Proximal tibiofibular osteoarthritis presenting as pain after total knee arthroplasty treated successfully with fusion of the proximal tibial-fibular joint

Proximal Tibiofibular Dislocation in Closing-Wedge High Tibial Osteotomy Increases the Risk of Medium and Long-Term Total Knee Replacement

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