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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 1, pp 129–133 | Cite as

Changes in patellofemoral alignment do not cause clinical impact after open-wedge high tibial osteotomy

  • Yong Seuk Lee
  • Sang Bok Lee
  • Won Seok Oh
  • Yong Eok Kwon
  • Beom Koo LeeEmail author
Knee

Abstract

Purpose

The objectives of this study were (1) to evaluate the clinical and radiologic outcomes of open-wedge high tibial osteotomy focusing on patellofemoral alignment and (2) to search for correlation between variables and patellofemoral malalignment.

Methods

A total of 46 knees (46 patients) from 32 females and 14 males who underwent open-wedge high tibial osteotomy were included in this retrospective case series. Outcomes were evaluated using clinical scales and radiologic parameters at the last follow-up. Pre-operative and final follow-up values were compared for the outcome analysis. For the focused analysis of the patellofemoral joint, correlation analyses between patellofemoral variables and pre- and post-operative weight-bearing line (WBL), clinical score, posterior slope, Blackburn Peel ratio, lateral patellar tilt, lateral patellar shift, and congruence angle were performed.

Results

The minimum follow-up period was 2 years and median follow-up period was 44 months (range 24–88 months). The percentage of weight-bearing line was shifted from 17.2 ± 11.1 to 56.7 ± 12.7 %, and it was statistically significant (p < 0.01). Regarding the clinical results, statistical significance was observed using all scores (p < 0.01). In the radiologic evaluation, patellar descent was observed with statistical significance (p < 0.01). Last follow-up lateral patellar tilt was decreased with statistical significance (p < 0.01). In correlation analysis between variables of patellofemoral malalignment, the pre-operative weight-bearing line showed an association with the change in lateral patellar tilt and lateral patellar shift (correlation coefficient: 0.3).

Conclusion

After open-wedge high tibial osteotomy, clinical results showed improvement, compared to pre-operative values. The patellar tilt and lateral patellar shift were not changed; however, descent of the patella was observed. Therefore, mild patellofemoral problems should not be a contraindication of the open-wedge high tibial osteotomy.

Level of evidence

Case series, Level IV.

Keywords

Knee Osteoarthritis Open-wedge high tibial osteotomy Patellofemoral indices 

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2014

Authors and Affiliations

  • Yong Seuk Lee
    • 1
  • Sang Bok Lee
    • 2
  • Won Seok Oh
    • 2
  • Yong Eok Kwon
    • 1
  • Beom Koo Lee
    • 2
    Email author
  1. 1.Department of Orthopaedic Surgery, Bundang HospitalSeoul National University College of MedicineSeoulKorea
  2. 2.Department of Orthopaedic Surgery, Gil Medical Center, Gil HospitalGachon University School of MedicineIncheonKorea

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