Patellar height and the inclination of the tibial plateau after high tibial osteotomy

Brouwer, Reinoud W; Bierma-Zeinstra, S.; Koeveringe, A J van; Verhaar, Jan A N

doi:10.1302/0301-620x.87b9.15972

Cited by 196 publications

(203 citation statements)

References 16 publications

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“…To some extent, our study showed a similar distribution of patellae norma, alta and infera as reported in the literature at the site of different surgical indications [12,[30][31][32]. In some cases, our results demonstrated great variations in the determined values.…”

Section: Discussionsupporting

confidence: 87%

Comparison of five patellar height measurement methods in 90° knee flexion

Anagnostakos

Lorbach

Reiter

et al. 2011

International Orthopaedics (SICOT)

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Purpose The aim of this prospective study was to evaluate the patellar height in 90°knee flexion. Methods A total of 85 patients with 95 knee joints were included in the study. Patellar height was measured according to the Blackburne-Peel, Labelle-Laurin, InsallSalvati, Linclau, and Caton-Deschamps methods in the whole group and in subgroups based on age, gender, and side.Results The BP-ratio showed a patella norma in 45 cases, and in 25 cases a patella alta and infera, respectively. The Labelle-Laurin method determined a patella norma in eight knees, in 35 a patella alta and in 52 a patella infera. The ISratio revealed a patella norma in 52 patients, a patella alta in six and in 37 a patella infera. The Linclau method demonstrated in 52 cases a patella norma, in 17 a patella alta and in 26 a patella infera. The CD-ratio showed the highest values of a patella norma among all tested methods in 67 knees, whereas a patella alta was evident in 13 and a patella infera in 15 cases. In the subgroups, discrepancies depended on the subgroup and method used. Conclusions Our results demonstrate a method-dependent discrepancy in the measurement of patellar height. A future study should evaluate this effect in a direct comparison between 30°and 90°knee flexion.

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Section: Discussionsupporting

confidence: 87%

Comparison of five patellar height measurement methods in 90° knee flexion

Anagnostakos

Lorbach

Reiter

et al. 2011

International Orthopaedics (SICOT)

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“…Depending on the surgical technique and postoperative management, alterations in patellar height can be induced [2,3,6,11,14,16,21]. Open wedge osteotomy (OWO) proximal to the tibial tuberosity, which is gaining popularity in recent years, has been reported to cause patella baja [6,12,21].…”

Section: Introductionmentioning

confidence: 99%

The influence of open and closed high tibial osteotomy on dynamic patellar tracking: a biomechanical study

Gaasbeek

Welsing

Barink

et al. 2007

Knee Surg Sports Traumatol Arthr

123

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High tibial osteotomy (HTO) can cause alterations in patellar height, depending on the surgical technique, the amount of correction and the postoperative management. Alterations in patella location after HTO may lead to postoperative complications. However, information on changes in dynamic patellar kinematics following HTO is very limited. We conducted a biomechanical study, to analyze the effect of open (OWO) and closed wedge osteotomy (CWO) on patellar tracking. Using an inventive experimental setup, we studied the 3D dynamic patellar tracking in ten cadaver knees before and after valgus HTO. In each specimen, corrections of 7°and 15°of valgus according to, both, the OWO and CWO technique, were performed. Patellar height significantly increased with CWO and decreased with OWO. Both, OWO and CWO led to significant changes in the patellar tracking parameters tilt and rotation. We also found significant differences between OWO and CWO. Valgus high tibial osteotomy increased the medial patellar tilt and reduced the medial patellar rotation. These effects were more profound after OWO. No significant differences were found for the effect on medial-lateral patellar translation. These observations can be taken into consideration in the decision whether to perform an OWO or a CWO in a patient with medial compartment osteoarthritis of the knee.

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“…However, the traditional osteotomy techniques also create alignment changes in the sagittal plane, which can adversely affect knee biomechanics and kinematics. Closing wedge osteotomies have been shown to decrease posterior tibial slope [25][26][27], whereas opening wedge osteotomies cause an increase in posterior tibial slope [25,28]. These changes can adversely affect postsurgical outcomes in patients with concomitant ligamentous laxity or patients that eventually require arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

The Coronal Plane High Tibial Osteotomy. Part 1: A Clinical and Radiographic Analysis of Intermediate Term Outcomes

Baumgarten

Fealy

Lyman

et al. 2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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The coronal plane high tibial osteotomy is a novel technique that is used to treat tibiofemoral malalignment. The authors hypothesize that the coronal plane high tibial osteotomy is (1) efficacious in treating both varus and valgus tibiofemoral malalignment; (2) does not alter the slope of the proximal tibia; and (3) does not alter the relationship between the patella and tibial tubercle. A retrospective review of 25 patients with tibiofemoral malalignment (19 varus/6 valgus) treated with a coronal plane osteotomy with a minimum of 2-year follow-up was performed. A Kaplan-Meyer survival curve was performed using knee arthroplasty and a Hospital for Special Surgery (HSS) knee score <70 as failure criteria. The Insall-Salvati ratio and the proximal tibial slope were measured. A p value of 0.05 was considered significant. At 60-month follow-up, knees with initial varus malalignment had an 84% survival rate using both knee arthroplasty and the HSS score as endpoints. Knees with initial valgus malalignment had an 84 and 60% survival rate using knee arthroplasty and the HSS score as endpoints, respectively. There was no statistically significant change in the Insall-Salvati ratio and proximal tibial slope after coronal plane osteotomy. The coronal plane osteotomy is efficacious in treating varus and valgus tibiofemoral malalignment and does not alter the patellar-tibial tubercle relationship or the posterior tibial slope [case series (level of evidence: IV)].

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Patellar height and the inclination of the tibial plateau after high tibial osteotomy

Cited by 196 publications

References 16 publications

Comparison of five patellar height measurement methods in 90° knee flexion

Comparison of five patellar height measurement methods in 90° knee flexion

The influence of open and closed high tibial osteotomy on dynamic patellar tracking: a biomechanical study

The Coronal Plane High Tibial Osteotomy. Part 1: A Clinical and Radiographic Analysis of Intermediate Term Outcomes

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