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Changes in the Contact Stress Distribution Pattern of the Patellofemoral Joint After Medial Open-Wedge High Tibial Osteotomy : An Evaluation Using Computed Tomography Osteoabsorptiometry
| Title: | Changes in the Contact Stress Distribution Pattern of the Patellofemoral Joint After Medial Open-Wedge High Tibial Osteotomy : An Evaluation Using Computed Tomography Osteoabsorptiometry |
| Authors: | Kameda, Toshiaki Browse this author | | Kondo, Eiji Browse this author →KAKEN DB | | Onodera, Tomohiro Browse this author | | Iwasak, Koji Browse this author | | Onodera, Jun Browse this author | | Yasuda, Kazunori Browse this author | | Iwasaki, Norimasa Browse this author |
| Keywords: | high tibial osteotomy | | knee osteoarthritis | | patellofemoral joint | | medial open-wedge |
| Issue Date: | Apr-2021 |
| Publisher: | SAGE Publications |
| Journal Title: | Orthopaedic journal of sports medicine |
| Volume: | 9 |
| Issue: | 4 |
| Start Page: | 2325967121998050 |
| Publisher DOI: | 10.1177/2325967121998050 |
| Abstract: | Background: Medial open-wedge high tibial osteotomy (OWHTO) theoretically causes distalization and lateralization of the tibial tuberosity and the patella. Purpose/Hypothesis: The purpose of the study was to identify any changes in the stress distribution of subchondral bone density across the patellofemoral (PF) joint before and after OWHTO through the use of computed tomography (CT) osteoabsorptiometry. We hypothesized that OWHTO would alter the distribution of contact stress in the PF joint. Study Design: Case series; Level of evidence, 4. Methods: A total of 17 patients (17 knees) who underwent OWHTO were enrolled in this study between September 2013 and September 2015. All patients underwent radiologic examination preoperatively and at 1 year postoperatively, and the distribution patterns of subchondral bone density through the articular surface of the femoral trochlea and patella were assessed preoperatively and >1 year postoperatively using CT osteoabsorptiometry. The quantitative analysis of the obtained mapping data focused on location of the high-density area (HDA) through the articular surface of the PF joint. The percentage of HDA at each divided region of the articular surface of the femoral trochlea and the patella was calculated. Results: In the radiologic evaluation, the Blackburne-Peel ratio was significantly reduced (P < .001) after surgery, and the tilting angle of the patella was significantly decreased (P < .001). On CT evaluation, the percentage of HDA in the lateral notch and lateral trochlea of the femur and in the medial portion of the lateral facet of the patella increased significantly after OWHTO surgery (P <= .038). Conclusion: OWHTO significantly increased the stress distribution pattern of the lateral trochlea of the femur and the medial portion of the lateral facet of the patella. The procedure significantly lowered the patellar height and significantly decreased the patellar tilting angle after surgery. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/81596 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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