Changes in patellar height and posterior tibial slope angle following uniplanar medial opening wedge high tibial osteoto
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ORIGINAL PAPER
Changes in patellar height and posterior tibial slope angle following uniplanar medial opening wedge high tibial osteotomy using a novel wedge-shaped spacer implanation concurrent with proximal partial fibulectomy Xiangtian Deng 1,2 & Wei Chen 2 & Kuo Zhao 2 & Jian Zhu 1 & Hongzhi Hu 2 & Xiaodong Cheng 2 & Zhongzheng Wang 2 & Yuchuan Wang 2 & Zhanchao Tan 2 & Zhipeng Ye 1 & Yingze Zhang 1,2 Received: 30 June 2020 / Accepted: 25 August 2020 # SICOT aisbl 2020
Abstract Purpose The purpose of this study was to evaluate changes of patellar height and posterior tibial slope angle following uniplanar medial opening wedge high tibial osteotomy using a novel wedge-shaped spacer implanation concurrent with proximal partial fibulectomy. Methods All patients who underwent uniplanar medial opening wedge high tibial osteotomy using a novel wedge-shaped spacer implanation concurrent with proximal partial fibulectomy between January 2017 and February 2019 were included and assessed retrospectively. Radiological assessment was made in terms of the changes in patellar height and posterior tibial slope angle between pre-operative and post-operative radiographs. Results Thirty-five patients (9 males and 26 females) with a mean age of 57.3 years (range 50.8–64.2 years) were enrolled in this study protocol and demonstrated decreased posterior tibial slope angle post-operatively (9.7° ± 2.5° pre-operatively and 7.3° ± 1.8° post-operatively, P < 0.001). Patellar height was unchanged significantly post-operatively (Caton–Deschamps: 0.83 ± 0.12 pre-operatively and 0.82 ± 0.09 post-operatively, P > 0.05). Conclusions Uniplanar medial opening wedge high tibial osteotomy using a novel wedge-shaped spacer implanation concurrent with proximal partial fibulectomy can decrease posterior tibial slope and maintain the patellar height. Keywords Uniplanar open wedge high tibial osteotomy . Medial compartmental knee osteoarthritis . Proximal partial fibulectomy . Posterior tibial slope . Patella height
Introduction Xiangtian Deng, Wei Chen and Kuo Zhao contributed equally to this work. Level of evidence IV Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00264-020-04786-5) contains supplementary material, which is available to authorized users. * Yingze Zhang [email protected] 1
School of Medicine, Nankai University, Tianjin 300071, People’s Republic of China
2
Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050051, Hebei, People’s Republic of China
Medial compartmental knee osteoarthritis with loss of knee extension, which leads to pain and a limited range of motion, is the common reason for patients to the orthopaedics department [1]. Several studies [2, 3] have reported that varus malalignment aggravates tibiofemoral contact pressure and is related to a structural progression in medial compartment knee osteoarthritis. Proximal partial fibulectomy, based on the theory of nonuniform settlement [4], is a m
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