High tibial osteotomy (HTO) is a treatment option for relatively young active patients with isolated medial compartment arthritis of the knee. Medial open wedge osteotomies offer manageable control of correction, but can elicit patella infera as a result of distalization of the tibial tubercle. Aim of this study was to report clinical and imaging results achieved with the use of particular open wedge high tibial osteotomy by incorporating the tibial tubercle into osteotomy line (TT-OWHTO) to preserve patella height.

Objectives
In this report, we introduce our clinical and radiological results of a new HTO technique, thanks to the tibial tubercle is preserved and remains attached to the proximal fragment . This prevents any surgical trauma to the extensor apparatus and prevents patella infera otherwise the biplanar nature of this osteotomy technique provides stability and a wider area for healing.

Study Design & Methods
The study is a retrospective analysis of 45 consecutive active patients (38 male ,7 female) average age 40.2 years who underwent this procedure from January 2015. A biplanar open wedge tibial osteotomy was performed and stabilised with a medial locking plate plus one transtuberositary screw. Patients were allowed full weight bearing at 6 weeks. Continue passive motion was allowed one day after surgery up to 90 degrees within the first month. Preoperative and postoperative function was recorded on the IKDC score, Kuala P-F score, EQ-VAS and Tegner activity scale. Max follow up was 60 months. Radiological patella height was measured with Insall-Salvati index preoperative and at last follow up.

Results

All patients had healing of the osteotomy with no delayed union. All the patients reported improvement in symptoms with an average preoperative IKDC score from preoperative value 49.7 to 92.3 at last follow up. Kuala PF score improve from 67.2 preoperative value to 91.4. EQ-VAS self-assessment of quality of life reported a pre-operative value of 41.2 to 92.2 at last follow up. There was 2.5-point average improvement in Tegner activity scale. Patella height was not altered with median preoperative value of 0,84± 0.1 and final follow up value of 0,81± 0.2.

Conclusions

TT-OWHTO showed to be able to achieve good clinical and radiological results maintaining patella height inalterated guaranteeing safety and reproducibility requirements of the traditional technique.

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5 Years Of Clinical And Radiological Results With Biplanar Tibial Open-Wedge Osteotomy: Feasible Option To Prevent Patella Infera?

5 Years Of Clinical And Radiological Results With Biplanar Tibial Open-Wedge Osteotomy: Feasible Option To Prevent Patella Infera?

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5 Years Of Clinical And Radiological Results With Biplanar Tibial Open-Wedge Osteotomy: Feasible Option To Prevent Patella Infera?

5 Years Of Clinical And Radiological Results With Biplanar Tibial Open-Wedge Osteotomy: Feasible Option To Prevent Patella Infera?

Background

Results

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