Summary

The radiographic alignment after high tibial osteotomy was not showed correlation with the adduction moment of the knee joint after the operation.

Abstract

Purpose

The purpose of this study was to evaluate changes in gait biomechanics and correlation between gait parameters and radiographic outcomes during ground level walking before and two years more after medial opening wedge high tibial osteotomy.

Materials And Methods

21 patients with varus malalignment, medial compartment knee osteoarthritis performed 3-dimensional gait analysis preoperatively and at 6 and 24 months or more follow-up period after medial opening wedge high tibial osteotomy. The kinematic and kinetic parameters of knee varus angle, first peak knee adduction moment in both operated and non-operated knees were evaluated during gait. Correlation between gait parameters and radiographic coronal plane alignment was also evaluated.

Results

Varus angle and first peak adduction moment in mid-stance phase and radiographic alignment of the knee joint were reduced significantly in operated limb at 6 and more than 24 months (24-62, mean 34.8) after the operation.
There was no difference of the varus angle and first peak adduction moment and radiographic alignment of the knee joint from 6 months and at the last follow-up postoperatively. However, in the group of the patients who has more than five degrees of valgus angle in the mid-stance phase at 6 months after operation (11 patients), the valgus angle was reduced, the adduction moment was increased and the radiographic alignment was improved significantly at the last follow-up compared with 6 months after the operation (p=0.006, p=0.003, p=0.038).
The varus angle & adduction moment in the mid-stance phase were correlated positively at 6 month and more than 24 months after the operation (p=0.007, p=0.043). The radiographic alignment was correlated positively with the varus angle of the knee joint at the last follow-up after the operation (p=0.031). But, the radiographic alignment had no correlation with the varus angle of the knee joint at 6 months after operation and had no correlation with the adduction moment at 6 months and the last follow-up after the operation.

Conclusions

In case the coronal angle of the knee joint in the mid-stance phase was more than five degrees of valgus after high tibial osteotomy in patients with medial knee osteoarthritis, adaptation was found over time. The radiographic alignment after high tibial osteotomy was not showed correlation with the adduction moment of the knee joint after the operation.