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Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

In this study, postoperative changes in the posterior tibial slope angle and clinical outcomes following open-wedge high tibial osteotomy were evaluated.

Methods

This study included 39 knees (18 left, 21 right) of 35 patients (three male, 32 female; median age, 53 years; age range 37–64 years) with symptomatic isolated medial joint osteoarthritis who underwent open-wedge high tibial osteotomy and fixation with a Puddu plate. The patients were clinically assessed according to the Lysholm knee score, a visual analogue pain scale, and a patient satisfaction questionnaire. Radiological assessment was made according to the changes in the posterior tibial slope angle and the correlation between these changes and clinical signs. The median follow-up period was 11 years (range 7–14 years).

Results

Significant improvements were observed in the preoperative and postoperative clinical scores of the Lysholm knee scale, visual analogue pain scale, and patient satisfaction questionnaire (p < 0.05). Radiological assessment showed that the posterior tibial slope angle was significantly higher during the postoperative and follow-up periods (p  0.05). There was no correlation between the postoperative Lysholm scores and the increase in the posterior tibial slope angle (p = n.s.).

Conclusions

We conclude that both the conventional Puddu plate design and its anteromedial plate placement are what increase the tibial slope after an opening-wedge proximal tibial osteotomy. Therefore, current new plate design may help preserve the posterior tibial slope angle.

Level of evidence

IV.

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Conflict of interest

The authors declare that they have no conflicts of interest. They received no financial support for the research and/or authorship of this article.

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Authors and Affiliations

  1. Department of Orthopaedics, Istanbul Baskent University Hospital, Istanbul, Turkey

    Omer Ozel

  2. Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Atakent Mahallesi, Turgut Ozal Caddesi, No: 1, Kucukcekmece, 34303, Istanbul, Turkey

    Bulent Yucel & Serhat Mutlu

  3. Department of Orthopaedics, Silivri Government Hospital, Istanbul, Turkey

    Osman Orman

  4. Department of Orthopaedics, Taksim Training and Research Hospital, Istanbul, Turkey

    Harun Mutlu

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  1. Omer Ozel
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  2. Bulent Yucel
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  3. Serhat Mutlu
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Correspondence to Serhat Mutlu.

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Ozel, O., Yucel, B., Mutlu, S. et al. Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc 25, 314–318 (2017). https://doi.org/10.1007/s00167-015-3571-2

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  • DOI: https://doi.org/10.1007/s00167-015-3571-2

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