Patellofemoral Alignment and Anterior Knee Pain After Closing- and Opening-Wedge Valgus High Tibial Osteotomy

Song, Il-Hyeon; Song, Eun-Kyoo; Seo, Hyoung‐Yeon; Lee, Keun-Bae; Yim, Ji Hyeon; Seon, Jong Keun

doi:10.1016/j.arthro.2012.02.002

Cited by 47 publications

(55 citation statements)

References 27 publications

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“…Other studies used different standards such as IKS knee score, 18 and K/L score. 19,20 Clinical Outcomes There were no statistically significant differences in Lysholm knee score, maximal flexion, VAS (medium-short-term), VAS (long-term), HSS score, and Tegner activity score. The operation times were significantly shorter in the OWO groups as compared with the CWO groups (95% CI: À26.45, À11.41, p < 0.001) (►Table 2).…”

Section: Study Characteristics and Qualitymentioning

confidence: 89%

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Sun

Zhou

et al. 2016

J Knee Surg

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Young active patients with medial knee osteoarthritis (OA) combined with varus leg alignment can be treated with high tibial osteotomy (HTO) to stop the progression of OA and avoid or postpone total knee arthroplasty (TKA). Closing-wedge osteotomy (CWO) and opening-wedge osteotomy (OWO) are the most commonly used osteotomy techniques. The purpose of this study was to compare the clinical and radiologic outcomes and complications between OWO and CWO. We retrospectively evaluated 23 studies including 17 clinical trials from published databases from their inception to May 2015. We evaluated the clinical outcomes including operation time, visual analog scale (VAS), maximal flexion, and hospital for special surgery knee (HSS) score. The radiologic outcomes included patellar height measured by posterior tibial slope angle, hip-knee-ankle (HKA) angle, femorotibial (FT) axis, and limb length. Complications recorded included the incidence of deep vein thrombosis (DVT), common peroneal nerve injury, opposite cortical fracture, etc. There were no differences in most of the clinical outcomes except the operation time. OWO increased the posterior slope angle and limb length, decreased the patellar height, and provided higher accuracy of correction. CWO led to a higher incidence of opposite cortical fracture.

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Section: Study Characteristics and Qualitymentioning

confidence: 89%

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Sun

Zhou

et al. 2016

J Knee Surg

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“…21 Previous studies showed that OWHTO commonly results in anterior knee pain and severe postoperative anterior knee pain, which is correlated with severe patellofemoral arthritis. 16,19 Recently, OWHTO below the tibial tuberosity has aroused attention and shown significant improvements in radiographic parameters and knee function without changes in patellar height or PTS. [22][23][24][25][26] An early study reported that this technique could lead to the potential for fracture of the tibial tubercle fragment.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies addressed that OWHTO results in a decrease in the patellar height which may lead to patella baja. [12][13][14][15][16][17][18] Some studies highlighted that the change in patellar height also affects patellar tracking, which also results in alterations in patellofemoral congruency, and contact stress would thus increase cartilage pressure and lead to patellofemoral degeneration or patellofemoral OA. 17,[19][20][21] In contrast, some studies reported that the changes in patellofemoral alignment do not have a clinical impact after OWHTO.…”

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confidence: 99%

Patellar Height Is Not Altered When the Knee Axis Correction Is Less than 15 Degrees and Has Good Short-Term Clinical Outcome

et al. 2019

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The objectives of our study were to evaluate (1) patellar height changes when the knee axis correction was < 15 degrees and (2) the clinical effect after open wedge high tibial osteotomy (OWHTO). Sixty-nine patients (69 knees) undergoing OWHTO between January 2016 and June 2017 were enrolled in this prospective study. All patients underwent OWHTO using a three-dimensional (3D)-printed patient-specific instrument. We used X-ray and lower-limb computed tomography scan to measure the osteotomy angle, patellar height, and other patellofemoral joint indices. We used the hospital for special surgery knee (HSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Kujala's scores to evaluate the clinical outcome. All knee axis corrections were less than 15 degrees. The change in posterior tibial slope (PTS) did not show a statistically significant difference. We observed that the patellar height was not altered when we used femur referenced measurement method. The change in modified Miura–Kawamura index (MKI) and Femoral patellar height index (FPHI) did not show a statistically significant difference. The differences in Blackburne–Peel index (BPI) and Caton–Deschamps index (CDI) were statistically significant, decreasing from 0.91 ± 0.12 and 1.06 ± 0.11 preoperatively to 0.79 ± 0.13 and 0.95 ± 0.11 postoperatively, respectively. In the axial plane, we did not observe a change in lateral patellar shift (LPS), but we found that lateral patellar tilt (LPT) showed a significant decrease from 8.67 ± 2.60 degrees preoperatively to 6.13 ± 2.30 postoperatively, respectively. The tuberositas tibae–trochlear groove (TT–TG) distance showed a significant decrease after OWHTO from 14.30 ± 4.10 mm preoperatively to 11.52 ± 3.63 mm postoperatively. The clinical score showed a significant increase after OWHTO, and all patients were satisfied with the outcome. After OWHTO, the patellar height was not altered when the knee axis correction was < 15 degrees. It was also found that there was still lateral displacement of the patella. Internal rotation of the distal tibia is an important cause of LPT reduction. After OWHTO, all patients achieved satisfactory clinical outcomes. At 1-year short-term follow-up, patients did not report discomfort in the patellofemoral joint. The Level of Evidence for this study was IV.

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“…KL is the earliest and by far the most commonly used global scale that gives an overall score of OA severity ranging from zero to four [38,43]. The confirmation of several features were graded as an evidence of OA: grade 0, no radiographic findings of OA; grade 1, possible osteophytes and doubtful narrowing of joint space; grade 2, definite osteophytes and narrowing of joint space; grade 3, moderate multiple osteophytes and definite narrowing of joint space; and grade 4, large osteophytes and marked narrowing of joint space [38].…”

Section: Imaging Examinationmentioning

confidence: 99%

Changes in self-reported disability after performance-based tests in obese and non-obese individuals diagnosed with osteoarthritis of the knee

Coriolano

Aiken

Pukall

et al. 2014

Disability and Rehabilitation

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Obese individuals with knee OA may over-estimate their ability to perform physical activities, and may under-estimate their level of disability compared to non-obese individuals with knee OA. In addition, self-reported physical activity seems to be a strong indicator of disability in individuals with knee OA, particularly for individuals with a sedentary life style. Implications for Rehabilitation Osteoarthritis is a progressive joint disabling condition that restricts physical function and participation in daily activities, particularity in elderly individuals. Obesity is a comorbidity commonly associated with osteoarthritis and it appears to increase self-reported disability in those diagnosed with osteoarthritis of the knee. In a relatively small sample, this study recommends that rehabilitation professionals obtain self-report questionnaires of disability after performance-based tests in obese individuals with osteoarthritis of the knee as they are more likely to give an accurate representation of their level of ability at this time.

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Patellofemoral Alignment and Anterior Knee Pain After Closing- and Opening-Wedge Valgus High Tibial Osteotomy

Cited by 47 publications

References 27 publications

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Patellar Height Is Not Altered When the Knee Axis Correction Is Less than 15 Degrees and Has Good Short-Term Clinical Outcome

Changes in self-reported disability after performance-based tests in obese and non-obese individuals diagnosed with osteoarthritis of the knee

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