The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy—one of the causes affecting the patellofemoral joint?

Tseng, Tzu-Hao; Tsai, Yueh-Cheng; Lin, Kuan‐Yu; Kuo, Ying-Kuei; Wang, Jyh-Horng

doi:10.1007/s00264-018-3951-6

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…An increase in the posterior tibial slope could cause anterior translation of the tibia and increase the load on the anterior cruciate ligament [11,12]. An increased posterior tibial slope could also cause a redistribution of pressure into the posterior tibia in the anterior cruciate ligament-deficient knee, causing degenerative changes in articular cartilage [13] and an increase of vertical vector force onto the patellofemoral joint, which could lead to osteoarthritis of the patellofemoral joint [14,15]. In addition to the knee joint, it has been reported that the tibial slope also has important biomechanical implications on the ankle joint [31].…”

Section: Discussionmentioning

confidence: 99%

“…The increase in posterior tibial slope of the tibiofemoral joint leads to anterior translation of the tibia relative to the femur, thus developing an overload on the anterior cruciate ligament [11,12]. An increased posterior tibial slope of the tibiofemoral joint could also cause a redistribution of pressure into the posterior tibia in the anterior cruciate ligamentdeficient knee, resulting in degenerative change in articular cartilage [13] and an increase of vertical vector force onto the patellofemoral joint, which could lead to osteoarthritis of the patellofemoral joint [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Effect of the Osteotomy Inclination Angle in the Sagittal Plane on the Posterior Tibial Slope of the Tibiofemoral Joint in Medial Open-Wedge High Tibial Osteotomy: Three-Dimensional Computed Tomography Analysis

Chung

Choi

Kim

et al. 2021

JCM

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The posterior tibial slope of the tibiofemoral joint changes after medial open wedge high tibial osteotomy (MOWHTO), but little is known about the effect of the sagittal osteotomy inclination angle on the change in the posterior tibial slope of the tibiofemoral joint. The purpose of this study was to investigate the effect of the osteotomy inclination angle in the sagittal plane on changes in the posterior tibial slope after MOWHTO by comparing how anterior and posterior inclination affect the posterior tibial slope of the tibiofemoral joint. The correlation between the osteotomy inclination angle and the postoperative posterior tibial slope angle was also assessed. Between May 2011 and November 2017, 80 patients with medial compartment osteoarthritis who underwent MOWHTO were included. The patients were divided into two groups according to the sagittal osteotomy inclination angle on the 3D reconstructed model. Patients with an osteotomy line inclined anteriorly to the medial tibial plateau line were classified into group A (58 patients). Patients with posteriorly inclined osteotomy line were classified as group P (22 patients). In the 3D reconstructed model, the preoperative and postoperative posterior tibial slope, osteotomy inclination angle relative to medial tibial plateau line in sagittal plane, and gap distance and ratio of the anterior and posterior osteotomy openings were measured. The preoperative and postoperative hip-knee-ankle angle, weight-bearing line ratio, and posterior tibial slope were also measured using plain radiographs. In the 3D reconstructed model, the postoperative posterior tibial slope significantly increased in group A (preoperative value = 9.7 ± 2.9°, postoperative value = 10.7 ± 3.0°, p < 0.001) and decreased in group P (preoperative value = 8.7 ± 2.7°, postoperative value = 7.7 ± 2.7°, p < 0.001). The postoperative posterior tibial slope (group A = 10.7 ± 3.0°, group P = 7.7 ± 2.7°, p < 0.001) and posterior tibial slope change before and after surgery (group A = 1.0 ± 0.8°, group P = −0.9 ± 0.8°, p < 0.001) also differed significantly between the groups. The Pearson correlation coefficient was 0.875 (p < 0.001) for the osteotomy inclination angle, and multivariate regression analysis showed that the only significant factor among the variables was the sagittal osteotomy inclination angle (β coefficient = 0.216, p < 0.001). The posterior tibial slope changed according to the osteotomy inclination angle in the sagittal plane after MOWHTO. The postoperative posterior tibial slope tended to increase when the osteotomy line was inclined anteriorly with respect to the medial tibial plateau line but decreased when the osteotomy line was inclined posteriorly. To avoid inadvertent change of posterior tibial slope, close attention needs to be paid to maintaining the sagittal osteotomy line parallel to the medial joint line during MOWHTO.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of the Osteotomy Inclination Angle in the Sagittal Plane on the Posterior Tibial Slope of the Tibiofemoral Joint in Medial Open-Wedge High Tibial Osteotomy: Three-Dimensional Computed Tomography Analysis

Chung

Choi

Kim

et al. 2021

JCM

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“…Patellofemoral joint problems after OWHTO may be due to anterior translation of the proximal tibial fragment [36] or to medial patellar tilt increasing lateral patellofemoral pressure [37]. In contrast, a recent study with a mean 3 years' follow-up found no deterioration in patellofemoral cartilage associated with decreased patellar height [38].…”

Section: Discussionmentioning

confidence: 97%

Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope

Carissimi

Sautet

Charre

et al. 2021

Orthopaedics & Traumatology: Surgery & Research

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“…So, partial patellectomy was usually employed in treating CMP. Tibial tuberosity surgeries, consisting mainly of the tibial tuberosity osteotomy, tibial tuberosity anteversion, and tibial tuberosity elevation, by restoring the biomechanical force line of the patellofemoral joint could improve joint function, but it will promote the degeneration of PFJ to a certain extent [31]. Harrington et al reported that the McKeever patellar resurfacing prosthesis showed a beneficial long-term effect in the treatment of severe CMP, which is usually as a salvage procedure for advanced PFJOA [32].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Chondromalacia patellae: current options and emerging cell therapies

Zheng

et al. 2021

Stem Cell Res Ther

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Chondromalacia patellae (CMP), also known as runner’s knee, typically occurs in young patients, which is characterized by anterior knee pain (AKP) that is associated with visible changes in patellar cartilage. The initial pathological changes include cartilage softening, swelling, and edema. CMP is caused by several factors, including trauma, increased cartilage vulnerability, patellofemoral instability, bony anatomic variations, abnormal patellar kinematics, and occupation hazards. CMP may be reversible or may progress to develop patellofemoral osteoarthritis. Quadriceps wasting, patellofemoral crepitus, and effusion are obvious clinical indications. Additionally, radiological examinations are also necessary for diagnosis. Magnetic resonance imaging (MRI) is a non-invasive diagnostic method, which holds a promise in having the unique ability to potentially identify cartilage lesions. Modalities are conventionally proposed to treat cartilage lesions in the PF joint, but none have emerged as a gold standard, neither to alleviated symptoms and function nor to prevent OA degeneration. Recently, researchers have been focused on cartilage-targeted therapy. Various efforts including cell therapy and tissue emerge for cartilage regeneration exhibit as the promising regime, especially in the application of mesenchymal stem cells (MSCs). Intra-articular injections of variously sourced MSC are found safe and beneficial for treating CMP with improved clinical parameters, less invasiveness, symptomatic relief, and reduced inflammation. The mechanism of MSC injection remains further clinical investigation and is tremendously promising for CMP treatment. In this short review, etiology, MRI diagnosis, and treatment in CMP, especially the treatment of the cell-based therapies, are reviewed.

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The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy—one of the causes affecting the patellofemoral joint?

Cited by 12 publications

References 33 publications

Effect of the Osteotomy Inclination Angle in the Sagittal Plane on the Posterior Tibial Slope of the Tibiofemoral Joint in Medial Open-Wedge High Tibial Osteotomy: Three-Dimensional Computed Tomography Analysis

Effect of the Osteotomy Inclination Angle in the Sagittal Plane on the Posterior Tibial Slope of the Tibiofemoral Joint in Medial Open-Wedge High Tibial Osteotomy: Three-Dimensional Computed Tomography Analysis

Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope

Chondromalacia patellae: current options and emerging cell therapies

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