The effect of distal tibial tuberosity high tibial osteotomy on postoperative patellar height and patellofemoral joint d
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(2020) 15:466
RESEARCH ARTICLE
Open Access
The effect of distal tibial tuberosity high tibial osteotomy on postoperative patellar height and patellofemoral joint degeneration Changxiao Han1†, Xia Li2†, Xiangdong Tian3* , Jiping Zhao4, Liqun Zhou2, Yetong Tan3, Sheng Ma3, Yuanyi Hu3, Handong Chen1 and Ye Huang1
Abstract Background: Distal tibial tuberosity high tibial osteotomy (DTT-HTO) can prevent distalization of the tibial tuberosity and thus patellar infera. However, no studies on the clinical and radiological effects of DTT-HTO on the patellofemoral joint have been conducted. The purpose of the study was to evaluate the effect of DTT-HTO on patella height and patellofemoral joint congruity based on the severity of patellofemoral joint OA. Methods: Twenty-nine patients (33 knees) who underwent DTT-HTO and second-look arthroscopy when implant was removed between January 2018 and May 2020 were eligible for the study. Among them, 6 were males, and 23 were females, with ages from 51 to 78 years old. The Caton-Deschamps index (CDI), congruence angle (CA), and lateral patellar tilt (LPT) were measured to evaluate the effect of surgery on patellar height and patellofemoral joint congruity. The weight-bearing line ratio (WBLR) was measured to assess lower limb alignment. The cartilage lesion in the patellofemoral joint was assessed arthroscopically during surgery and implant removal by the International Cartilage Repair Society (ICRS) grading system at 18–24 months after surgery. The Hospital for Special Surgery (HSS) scale was used to evaluate knee joint function. Results: Twenty-nine patients were followed up for 18–28 months. The preoperative CDI, CA, and LPT changed from 0.92 ± 0.16 to 0.89 ± 0.14, from 5.52 ± 2.19 to 5.44 ± 2.27, and from 6.95 ± 2.88 to 6.54 ± 2.42, respectively, and the differences were not statistically significant (p > 0.05). The preoperative WBLR significantly increased from 16.72 ± 6.77 to 58.77 ± 7.69% (p < 0.001). The cartilage lesions in the patella and femoral trochlea did not progress significantly from the first- to the second-look arthroscopy, according to the ICRS grades (p > 0.05). The HSS score significantly improved from 50.64 ± 19.18 preoperatively to 67.33 ± 14.72, 81.63 ± 11.92, and 82.73 ± 8.05 at the 3month, 12-month, and last follow-up after surgery (p < 0.001). (Continued on next page)
* Correspondence: [email protected] † Changxiao Han and Xia Li contributed equally to this work. 3 Minimal Invasive Joint Department, Beijing University of Chinese Medicine Third Affiliated Hospital, No. 51 Anwai Xiaoguan Street, Chaoyang District, Beijing 100029, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and in
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