Veränderung der Patellahöhe nach „open“- und „closed wedge high tibial osteotomy“

Abstract

The clinical relevance of the observed changes in patella position must be clarified by prospective studies with strict criteria.

Better clinical results after closed- compared to open-wedge high tibial osteotomy in patients with medial knee osteoarthritis and varus leg alignment

“…A possible explanation could be that there was a patella baja after OWO, which could lead to patellofemoral complaints and a negative influence on clinical results. At the final follow‐up, there was a decrease in the CI in the OWO group compared to the preoperative CI values (0.9 vs. 1.0), which is comparable to the literature [7, 28]. The CI remained unchanged from preoperative to final follow‐up in the CWO group (both 1.0).…”

“…The CI remained unchanged from preoperative to final follow-up in the CWO group (both 1.0). Increases and decreases in this index following CWO have been described [7,28]. In a biomechanical study, Gaasbeek et al…”

Evaluation of Patellar Position before and After Medial Opening Wedge High Tibial Osteotomy: Radiographic and Computed Tomography Findings

“…However, there is confusion regarding the effect of a high tibial osteotomy on patellar height for closing and opening wedge osteotomies. Elevation and lowering of the patella have been reported for both techniques, often opposite to mechanical expectations ( 11 , 12 , 13 ). Recently, it has been stated that the opening wedge osteotomy may lower the patella ( 11 , 14 ).…”

“…Elevation and lowering of the patella have been reported for both techniques, often opposite to mechanical expectations ( 11 , 12 , 13 ). Recently, it has been stated that the opening wedge osteotomy may lower the patella ( 11 , 14 ). The conventional supratubercle horizontal opening wedge technique does reduce patellar height and increase sagittal tibial slope, because correction is primarily designed to correct the varus malalignment of the knee joint in coronal plane ( 14 ).…”

“…Other studies have been indicated that high tibial osteotomy result in confusion regarding whether the patella is raised or lowered, and the effects of these osteotomies on tibial slope and patellar tendon length are not clear (14, 1, 5, 16). Recently, it has been stated that the opening wedge osteotomy may lower the patella ( 11 , 14 ). The important point in this process is that the mechanical axis of the lower limbs must be corrected, as well as putting extensor mechanism and patella bone in the right position.…”