Retro-tubercular Biplanar Medial Opening-Wedge High Tibial Osteotomy Results in Superior Patellofemoral Alignment Versus Supra-tubercular Osteotomy

Cho, Joon Hee; Nam, Hee Seung; Ho, Jade Pei Yuik; Tu, Nguyen Thanh; Lee, Yong Seuk

doi:10.1016/j.arthro.2023.08.012

Arthroscopy: The Journal of Arthroscopic & Related Surgery

2024

DOI: 10.1016/j.arthro.2023.08.012

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Retro-tubercular Biplanar Medial Opening-Wedge High Tibial Osteotomy Results in Superior Patellofemoral Alignment Versus Supra-tubercular Osteotomy

Joon Hee Cho,

Hee Seung Nam,

Jade Pei Yuik Ho

et al.

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2024

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Cited by 3 publications

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Editorial Commentary: Biplanar Medial Opening-Wedge High Tibial Osteotomy: A Retrotubercular Technique Changes the Patellofemoral Alignment Less Than a Supratubercular Technique but May Increase the Tibial Slope and Complication Rates

Servant

2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Editorial Commentary: Biplanar Medial Opening-Wedge High Tibial Osteotomy: A Retrotubercular Technique Changes the Patellofemoral Alignment Less Than a Supratubercular Technique but May Increase the Tibial Slope and Complication Rates

Servant

2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Implant Removal After Medial Opening Wedge High Tibial Osteotomy Provides Implant-Related Pain Relief and Functional Improvement

Lee,

Shin,

Hong

et al. 2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Infratubercle Anterior Closing Wedge Osteotomy Corrects Sagittal Alignment without Affecting Coronal Alignment or Patellar Height

Onishi,

Kim,

Nakayama

et al. 2024

JCM

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Background: Excessive posterior tibial slope (PTS) has been associated with a higher risk of graft failure after anterior cruciate ligament reconstruction (ACLR). Although anterior closing wedge osteotomy (ACWO) can reduce the PTS, it may also change the coronal alignment and patellar height. Purpose: To elucidate the radiological outcomes after infratubercle ACWO, specifically to evaluate its influence on perioperative changes in patellar height. Methods: Patients who underwent infratubercle ACWO with combined ACLR with a minimum follow-up of 3 months were included. Surgery was indicated when the PTS was greater than 12°. Radiological evaluation included measurements of the hip–knee–ankle angle (HKA), PTS, femoral patellar height index (FPHI), and Caton–Deschamps index (CDI) preoperatively and 3 months postoperatively. Patellar height was classified as patella baja, normal, or alta based on CDI values. Knee recurvatum was measured preoperatively and at final follow-up. Results: A total of 21 patients with a mean age of 21.6 ± 3.0 years were included. Although HKA did not significantly change, significant corrections were achieved in the PTS from 14.5° ± 1.6° to 5.7° ± 1.0° (p < 0.001). No significant change in FPHI was found (preoperative: 1.33 ± 0.11 vs postoperative: 1.30 ± 0.09). Patellar height categories showed no significant differences pre- and postoperatively, while three patients (14.3%) changed their patellar height category (all moved up one category). Knee recurvatum increased significantly from 4.9° ± 2.9° preoperatively to 7.8° ± 3.1° at the final follow-up (p < 0.001). Conclusions: Precise sagittal correction was achieved after infratubercle ACWO without altering the coronal alignment and patella height. Level of Evidence: IV, Case series.

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Retro-tubercular Biplanar Medial Opening-Wedge High Tibial Osteotomy Results in Superior Patellofemoral Alignment Versus Supra-tubercular Osteotomy

Cited by 3 publications

References 38 publications

Editorial Commentary: Biplanar Medial Opening-Wedge High Tibial Osteotomy: A Retrotubercular Technique Changes the Patellofemoral Alignment Less Than a Supratubercular Technique but May Increase the Tibial Slope and Complication Rates

Editorial Commentary: Biplanar Medial Opening-Wedge High Tibial Osteotomy: A Retrotubercular Technique Changes the Patellofemoral Alignment Less Than a Supratubercular Technique but May Increase the Tibial Slope and Complication Rates

Implant Removal After Medial Opening Wedge High Tibial Osteotomy Provides Implant-Related Pain Relief and Functional Improvement

Infratubercle Anterior Closing Wedge Osteotomy Corrects Sagittal Alignment without Affecting Coronal Alignment or Patellar Height

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