Purpose To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (OWHTO) with respect to the patellofemoral joint and to assess whether patellofemoral osteoarthritis (OA) progression and alignment changes after OWHTO affect clinical outcomes. Methods Inclusion criteria were consecutive patients who underwent OWHTO from March 2005 to September 2013. Exclusion criteria were loss to follow-up within 2 years and absence of second-look arthroscopy findings at the time of plate removal. The clinical parameters, including anterior knee pain while climbing stairs, Japanese Orthopedic Association score, and Oxford Knee Score, were evaluated. Radiological outcomes, including weight-bearing line ratio, modified Blackburne-Peel ratio, posterior tibial slope, tilting angle, lateral shift ratio, and patellofemoral OA (Kellgren-Lawrence grade), were evaluated preoperatively and at the final follow-up. Cartilage status (International Cartilage Repair Society grade) was evaluated at the initial HTO and at plate removal. Results Fifty-three patients (60 knees) were included in this study. The mean follow-up was 58.2 ± 22.4 months. Two knees (3%) presented with mild anterior knee pain after OWHTO. The mean Japanese Orthopedic Association score (66.9 ± 11.2 to 91.2 ± 9.7) significantly improved ( P P P  = .033) significantly decreased after OWHTO, whereas no significant changes in posterior tibial slope ( P  = .511) and lateral shift ratio ( P  = .522) were observed. Radiologically, patellofemoral OA had progressed in 15 knees (27%), and arthroscopically patellofemoral cartilage degeneration had progressed in 27 knees (45%). However, there was no significant correlation between changes in patellofemoral alignment and clinical outcomes. Conclusions Changes in patellofemoral alignment and patellofemoral OA progression did not affect the clinical outcomes of OWHTO at mid-term follow-up. Level of Evidence Level IV, therapeutic case series.

Patellofemoral Osteoarthritis Progression and Alignment Changes after Open-Wedge High Tibial Osteotomy Do Not Affect Clinical Outcomes at Mid-term Follow-up.

Background:There have been little data concerning serial changes in the joint space width (JSW) and joint line convergence angle over the course of follow-up periods after closed-wedge high tibial osteotomy (CWHTO).Purpose:To evaluate serial changes in the JSW and joint line convergence angle after CWHTO.Study Design:Case series; Level of evidence, 4.Methods:A total of 100 computer-assisted CWHTOs with a minimum follow-up period of 3 years (mean, 4.4 years) were analyzed. Clinically, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was evaluated. Radiographically, the mechanical axis was measured preoperatively and postoperatively. The minimal JSW was measured as the shortest distance between the femur and the tibia. The convergence angle was measured as the angle between the tangent to the subchondral plates of the femoral condyle and the tibial plateau. Serial changes in these measurements were analyzed preoperatively; at 3 months, 6 months, 1 year, and 2 years postoperat...

Serial Changes in the Joint Space Width and Joint Line Convergence Angle After Closed-Wedge High Tibial Osteotomy.

Background The coronal subluxation of the proximal tibia relative to the distal femur is a common radiological finding in patients with knee osteoarthritis. The purpose was to evaluate whether the coronal subluxation was corrected after opening wedge high tibial osteotomy (OWHTO), and whether this subluxation was one cause of inconsistency between the actual and predicted alignments (correction loss). Methods Fifty-one patients (55 knees) were treated with OWHTO. The change of location between the intersection points of the femoral and tibial axes on the tibial plateau (subluxation-C), the change of location between the lines through the most lateral points of the lateral femoral and tibial condyles (subluxation-L), and joint space angle (JSA) were compared in standing knee radiographs before and one year after OWHTO. The subluxation-C and subluxation-L were converted to a percentage of the tibial plateau width. Results The mean subluxation-C of 6.5% before OWHTO significantly increased to a mean subluxation-C of 7.3% one year after OWHTO. The mean subluxation-L of 6.3% and JSA of 4.5° before OWHTO significantly decreased to a subluxation-L of 1.8% and JSA of 3.3° one year after OWHTO. The change in subluxation-L correlated with the change in femorotibial angle and correction loss ( r =0.634, P r =0.463, P Conclusion The proximal tibia shifted medially relative to the distal femur after OWHTO. This medial shift correlated with the correction loss. The coronal subluxation might be one cause of correction loss.

Coronal subluxation of the proximal tibia relative to the distal femur after opening wedge high tibial osteotomy

The effect of wedge and tibial slope angles on knee contact pressure and kinematics following medial opening-wedge high tibial osteotomy.

Purpose The aims of this study are to determine how opening-wedge high tibial osteotomy (HTO) affects cartilage health in the tibiofemoral (TF) joint and patella, and to explore relationships between TF and patellofemoral (PF) joint kinematics and cartilage health in HTO. Methods 14 knees (13 subjects) with medial TF osteoarthritis (OA) were examined before HTO and 6 and 12months after HTO using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) to evaluate cartilage health at the TF joint and patella. They were also examined using a validated 3D MR knee kinematics measurement to obtain 11 rotations and translations at both TF and PF joints. Results No statistically significant differences in overall TF or patellar dGEMRIC score were found at 6 or 12months after HTO. However three subjects had large decreases (mean 105ms) in TF dGEMRIC at 6months that recovered at 12months. Kinematics for these subjects were compared to subjects who did not have decreases in TF dGEMRIC at 6months ( n =5). Differences were observed between groups with HTO in anterior and proximal tibial translation (mean differences 3.05mm and 1.35mm), and patellar flexion (mean difference 3.65°). These changes were consistent between 6 and 12months, despite recovery of TF dGEMRIC values. Conclusions We did not find significant differences in TF or patellar dGEMRIC before and after HTO with all subjects, however there were differences in kinematics between subjects who had a decrease in TF dGEMRIC at 6months and those who did not. This suggests a link between joint kinematics and cartilage health in HTO. Clinical relevance The effect of opening-wedge high tibial osteotomy on cartilage GAG concentration may be linked to specific changes in knee kinematics following surgery

/pdf/cartilage-health-in-high-tibial-osteotomy-using-dgemric-tbnix33lo1.pdf

Cartilage health in high tibial osteotomy using dGEMRIC: Relationships with joint kinematics.

Although it is clear that opening-wedge high
tibial osteotomy (HTO) changes alignment in the coronal plane, which is
its objective, it is not clear how this procedure affects knee kinematics
throughout the range of joint movement and in other planes. Our research question was: how does opening-wedge HTO change
three-dimensional tibiofemoral and patellofemoral kinematics in
loaded flexion in patients with varus deformity?Three-dimensional
kinematics were assessed over 0° to 60° of loaded flexion using
an MRI method before and after opening-wedge HTO in a cohort of
13 men (14 knees). Results obtained from an iterative statistical
model found that at six and 12 months after operation, opening-wedge
HTO caused increased anterior translation of the tibia (mean 2.6
mm, p < 0.001), decreased proximal translation of the patella
(mean –2.2 mm, p < 0.001), decreased patellar spin (mean –1.4°,
p < 0.05), increased patellar tilt (mean 2.2°, p < 0.05) and
changed three other parameters. The mean Western Ontario and McMaster
Universities Arthritis Index improved significantly (p < 0.001)
from 49.6 (standard deviation (sd) 16.4) pre-operatively
to a mean of 28.2 (sd 16.6) at six months and a mean of
22.5 (sd 14.4) at 12 months. The three-dimensional kinematic changes found may be important
in explaining inconsistency in clinical outcomes, and suggest that
measures in addition to coronal plane alignment should be considered. Cite this article: Bone Joint J 2014; 96-B:1214–21.

Effect of opening-wedge high tibial osteotomy on the three-dimensional kinematics of the knee

Paper 144: Effect of Opening-wedge High Tibial Osteotomy on Three-dimensional Knee Kinematics

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Simon Horlick

Author Tools

Chat about Author

Papers

Effect of opening-wedge high tibial osteotomy on the three-dimensional kinematics of the knee

Cartilage health in high tibial osteotomy using dGEMRIC: Relationships with joint kinematics.

Paper 144: Effect of Opening-wedge High Tibial Osteotomy on Three-dimensional Knee Kinematics