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Factors of Patella Height in the Open Wedge High Tibial Osteotomy Patients

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Factors of Patella Height in the Open Wedge High Tibial Osteotomy Patients

Takashi Hoshino, MD, PhD, JAPAN Hiroki Katagiri, MD, PhD, JAPAN Tomomasa Nakamura, MD, PhD, JAPAN Nobutake Ozeki, JAPAN Yusuke Nakagawa, JAPAN Mai Katakura, MD, PhD, JAPAN Masaki Amemiya, MD, PhD, JAPAN Aritoshi Yoshihara, MD, JAPAN Kazuyoshi Yagishita, MD, PhD, JAPAN Ichiro Sekiya, MD, PhD, JAPAN Hideyuki Koga, Prof., MD, PhD, JAPAN

Tokyo Medical and Dental University, Tokyo, JAPAN

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee Patellofemoral

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Osteotomy

Patient Populations

Elderly

Diagnosis Method

X-ray

Summary: Patients with low preoperative CDI and the amount of change in tibial posterior slope may affect the postoperative patella height, and these factors should be considered a risk factor for patella baja after OWHTO.

?Introduction?
It is known that open wedge high tibial osteotomy (OWHTO) has a higher risk of postoperative patella baja compared to closed wedge high tibial osteotomy (CWHTO), and it’s important to examine the factors of patella height after OWHTO. The purpose of this study is to investigate the relationship among three different methods of measuring patella height and the factors that influence patella height after OWHTO.

?Materials and methods?
In the current study, 98 patients (43 males and 55 females) with OWHTO at our hospital between September 2017 to May 2020 who were followed up for 1 year were included. We analyzed the radiographs of 101 knees before OWHTO and 1year follow-up. The patella height was assessed by measuring the Insall-Salvati Index (ISI), Caton de Chams Index (CDI), and Blackbune Peel Index (BPI). Furthermore, multiple regression analysis was conducted with age, gender, BMI, preoperative CDI, preoperative % mechanical axis (% MA), amount of change in tibial posterior slope before and after OWHTO as the independent variables, and CDI at 1 year follow-up was used as the dependent variable.
?Results?
There was a strong correlation between CDI and BPI both before and after OWHTO (R = 0.78, p <0.01). CDI and BPI decreased significantly (CDI; p <0.01, BPI; p <0.01), whereas there was no significant difference in ISI. In addition, preoperative CDI and the amount of change in tibial posterior slop were factors that affected postoperative CDI.

?Discussion?
The current study suggested CDI and BPI may be useful for measuring patella height after OWHTO. In addition, patients with low preoperative CDI and the amount of change in tibial posterior slope may affect the postoperative patella height, and these factors should be considered a risk factor for patella baja after OWHTO. In the future, it will be necessary to investigate the relationship with postoperative clinical results.

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Factors of Patella Height in the Open Wedge High Tibial Osteotomy Patients

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