Abstract
We investigated whether there is a correlation between coronal plane correction magnitude and tibial slope in patients treated with medial open wedge high tibial osteotomy (OWHTO) and also measured changes in patellar height. Thirty-four knees treated with for varus deformities were retrospectively reviewed and the follow-up period of the patients was averaged 24.1 months. Preoperative and postoperative measurements of the Hospital for Special Surgery (HSS) score, Insall–Salvati index, posterior tibial slope angle, mechanical axis deviation, proximal medial tibial angle (PMTA) was used to determine. All patients had a significant increase in their HSS score postoperatively (P < 0.0001). There was no significant correlation between the differences in patellar heights (P = 0.368). The mechanical axis deviation was altered by a mean of 25.5 ± 10.9 mm and the difference was statistically significant (P < 0.05). The mean posterior tibial slope angle on preoperative radiographs was 9.0 ± 5.1°; on postoperative radiographs it was 11.7 ± 5.7° and the difference was statistically significant (P < 0.007). Seventeen knees (50%) demonstrated postoperative posterior tibial slope angle increases; 7 knees (21%) had a decrease in this angle, while 10 knees (29%) showed no change. Statistical analyses revealed that the mechanical axis deviation was not correlated with change in tibial slope (P = 0.837). Although we could not find a correlation between tibial slope change and the amount of coronal correction, 50% of our patients demonstrated increased tibial slope.
Similar content being viewed by others
References
Aglietti P, Rinonapoli E et al (1983) Tibial osteotomy for the varus osteoarthritic knee. Clin Orthop Relat Res 176:239–251
Agneskirchner JD, Hurschler C et al (2004) Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004. Arch Orthop Trauma Surg 124(9):575–584
Ahlback S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl 277:7–72
Bombaci H, Canbora K et al (2005) The effect of open wedge osteotomy on the posterior tibial slope. Acta Orthop Traumatol Turc 39(5):404–410
Brazier J, Migaud H et al (1996) Evaluation of methods for radiographic measurement of the tibial slope. A study of 83 healthy knees. Rev Chir Orthop Reparatrice Appar Mot 82(3):195–200
Brouwer RW, Bierma-Zeinstra SM et al (2005) Patellar height and the inclination of the tibial plateau after high tibial osteotomy. The open versus the closed-wedge technique. J Bone Joint Surg Br 87(9):1227–1232
Cullu E, Aydogdu S et al (2005) Tibial slope changes following dome-type high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 13(1):38–43
Fujisawa Y, Masuhara K et al (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10(3):585–608
Giffin JR, Vogrin TM et al (2004) Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 32(2):376–382
Hernigou P, Medevielle D et al (1987) Proximal tibial osteotomy for osteoarthritis with varus deformty: A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354
Hoell S, Suttmoeller J et al (2005) The high tibial osteotomy, open versus closed wedge, a comparison of methods in 108 patients. Arch Orthop Trauma Surg 125(9):638–643
Hohmann E, Bryant A et al (2006) The effect of closed wedge high tibial osteotomy on tibial slope: a radiographic study. Knee Surg Sports Traumatol Arthrosc 14(5):454–459
Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101(1):101–104
Lobenhoffer P, Agneskirchner J et al (2004) Open valgus alignment osteotomy of the proximal tibia with fixation by medial plate fixator. Orthopade 33(2):153–160
Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11(3):132–138
Marti RK, Verhagen RA et al (2001) Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one-year results. J Bone Joint Surg Am 83A(2):164–170
Noyes FR, Goebel SX et al (2005) Opening wedge tibial osteotomy the 3-triangle method to correct axial alignment and tibial slope. Am J Sports Med 33(3):378–387
Rodner CM, Adams DJ et al (2006) Medial opening wedge tibial osteotomy and the sagittal plane: the effect of increasing tibial slope on tibiofemoral contact pressure. Am J Sports Med 34(9):1431–1441
Rosenberg TD, Paulos LE et al (1988) The forty-five-degree posteroanterior flexion weight-bearing radiograph of the knee. J Bone Joint Surg Am 70(10):1479–1483
Waelchli B, Romero J (2001) Dislocation of the polyethylene inlay due to anterior tibial slope in revision total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 9(5):296–298
Westrich GH, Peters LE et al (1998) Patella height after high tibial osteotomy with internal fixation and early motion. Clin Orthop Relat Res 354:169–174
Windsor RE, Insall JN et al (1988) Technical considerations of total knee arthroplasty after proximal tibial osteotomy. J Bone Joint Surg Am 70(4):547–555
Wright JM, Heavrin B et al (2001) Observations on patellar height following opening wedge proximal tibial osteotomy. Am J Knee Surg 14(3):163–173
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ozalay, M., Ozkoc, G., Circi, E. et al. The correlation of correction magnitude and tibial slope changes following open wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthr 16, 948–951 (2008). https://doi.org/10.1007/s00167-008-0589-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-008-0589-8