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International Orthopaedics

, Volume 43, Issue 3, pp 605–610 | Cite as

The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy—one of the causes affecting the patellofemoral joint?

  • Tzu-Hao Tseng
  • Yueh-Cheng Tsai
  • Kuan-Yu Lin
  • Ying-Kuei Kuo
  • Jyh-Horng WangEmail author
Original Paper
  • 129 Downloads

Abstract

Purpose

For opening-wedge high tibial osteotomy, previous studies have shown that most osteotomies were anterior-inclined. The purpose of this study was to determine the effect of sagittal osteotomy inclination on the anteroposterior translation of osteomized fragments and discuss its possible impact on the patellofemoral joint.

Methods

We retrospectively measured the angle between the joint line and the sagittal osteotomy line. We also evaluated the anteroposterior translation of osteomized fragments by measuring the distance from the most posterior point of the tibial plateau to the tibial tuberosity and the anterior cortical line. Correlation between the sagittal osteotomy inclination and the anteroposterior translation of fragments was analyzed.

Results

The mean sagittal osteotomy inclination was 6.3 ± 8.4° anteriorly to the joint line and 82% of osteotomies were anterior-inclined. The anteroposterior translation of the osteomized fragments was moderately correlated to the sagittal inclination. Anterior-inclined osteotomy tends to result in the anterior translation of the proximal fragment.

Conclusion

High rates of anterior-inclined osteotomy have been described previously as well as in this study. Anterior-inclined osteotomy tends to result in the anterior translation of the proximal fragment. This may result in increased vertical vector force onto the patellofemoral joint, which further accelerates patellofemoral joint degeneration. Therefore, surgeons should attempt to perform parallel osteotomy or avoid anterior displacement of the proximal fragment if there is concern of anterior-inclined osteotomy.

Keywords

Osteotomy Tibial slope Anteroposterior translation Patellofemoral joint degeneration 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Tzu-Hao Tseng
    • 1
    • 2
  • Yueh-Cheng Tsai
    • 2
  • Kuan-Yu Lin
    • 2
  • Ying-Kuei Kuo
    • 2
  • Jyh-Horng Wang
    • 2
    Email author
  1. 1.Department of Orthopaedic SurgeryTao-Yuan General HospitalTaoyuan CityTaiwan
  2. 2.Department of Orthopaedic SurgeryNational Taiwan University HospitalTaipeiTaiwan

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