Journal Article

Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis

Yucel, Bulent, Orman, Osman, Mutlu, Serhat, Mutlu, Harun, Ozel, Omer

2017

Overview

Purpose In this study, postoperative changes in the posterior tibial slope angle and clinical outcomes following open-wedge high tibial osteotomy were evaluated. Methods This study included 39 knees (18 left, 21 right) of 35 patients (three male, 32 female; median age, 53 years; age range 37–64 years) with symptomatic isolated medial joint osteoarthritis who underwent open-wedge high tibial osteotomy and fixation with a Puddu plate. The patients were clinically assessed according to the Lysholm knee score, a visual analogue pain scale, and a patient satisfaction questionnaire. Radiological assessment was made according to the changes in the posterior tibial slope angle and the correlation between these changes and clinical signs. The median follow-up period was 11 years (range 7–14 years). Results Significant improvements were observed in the preoperative and postoperative clinical scores of the Lysholm knee scale, visual analogue pain scale, and patient satisfaction questionnaire ( p  < 0.05). Radiological assessment showed that the posterior tibial slope angle was significantly higher during the postoperative and follow-up periods ( p   0.05). There was no correlation between the postoperative Lysholm scores and the increase in the posterior tibial slope angle ( p   =  n.s.). Conclusions We conclude that both the conventional Puddu plate design and its anteromedial plate placement are what increase the tibial slope after an opening-wedge proximal tibial osteotomy. Therefore, current new plate design may help preserve the posterior tibial slope angle. Level of evidence IV.

• Publisher: Springer Berlin Heidelberg,John Wiley & Sons, Inc
• Subject: Adult / Arthritis / Bone Plates / Clinical outcomes / Female / Genu Varum - complications / Genu Varum - diagnostic imaging / Genu Varum - surgery / Humans / Knee / Knee Joint - diagnostic imaging / Knee Joint - surgery / Male / Medicine / Medicine & Public Health / Middle Aged / Orthopedics / Osteoarthritis / Osteoarthritis, Knee - complications / Osteoarthritis, Knee - diagnostic imaging / Osteoarthritis, Knee - surgery / Osteotomy - methods / Pain Measurement / Patient Satisfaction / Postoperative Period / Questionnaires / Radiography / Retrospective Studies / Surgical techniques / Tibia - diagnostic imaging / Tibia - surgery / Treatment Outcome