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Patellar Height Decrease After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique

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Patellar Height Decrease After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique

Robert Ferrer-Rivero, MD, SPAIN Oriol Pujol, MD, SPAIN Josep Ferrer-Rivero, MD, SPAIN Gabriel Oliver, MD, PhD, SPAIN

Hospital Universitari de Bellvitge, Barcelona, SPAIN

2025 Congress ePoster Presentation 2025 Congress Not yet rated

Anatomic Location

Knee Patellofemoral Tibio - Fibular

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Osteotomy

Diagnosis Method

X-ray

Summary: Both techniques are good for performing a HTO, but it is important to remain vigilant, specially in the OW-HTO, to avoid unwanted changes in the patellar height.

Purpose

The two most commonly used techniques for performing a knee valgus osteotomy are the opening wedge high tibial osteotomy (OW-HTO) and the closing wedge high tibial osteotomy (CW-HTO). The objective of this study was to compare the patellar height between these two surgical procedures.

Methods

This is a retrospective cohort study. All OW-HTO and CW-HTO procedures operated on between 2018 and 2020 in our institution were included. We analysed their functional outcomes (KOOS-12, Tegner activity scale, pain and satisfaction) and radiological outcomes (HKA, MPTA, tibial slope and patellar height).

Results

Fifty-one patients met the inclusion criteria (27 OW-HTO and 24 CW-HTO). Our study did not find any difference in patellar height following CW-HTO, however, statistically significant differences were observed after OW-HTO, where the mean Caton Deschamps Index decreased 0.17 points (p<0.001).
Good to excellent functional outcomes, significant pain reduction (>6 points) and high patient satisfaction where found (>9/10) in both groups. Both techniques yielded excellent radiological outcomes in coronal plane alignment.

Conclusion

Both techniques are good option for performing a HTO, but it is important to remain vigilant when performing these techniques, specially the OW-HTO, to avoid unwanted changes in the patellar height.

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Patellar Height Decrease After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique

Patellar Height Decrease After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique

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Patellar Height Decrease After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique

Patellar Height Decrease After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique

Purpose

Methods

Results

Conclusion