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Effect of the Inverted V-Shaped Osteotomy on Patellofemoral Joint and Tibial Morphometry as Compared With the Media Opening Wedge High Tibial Osteotomy
| Title: | Effect of the Inverted V-Shaped Osteotomy on Patellofemoral Joint and Tibial Morphometry as Compared With the Media Opening Wedge High Tibial Osteotomy |
| Authors: | Kondo, Eiji Browse this author →KAKEN DB | | Yabuuchi, Koji Browse this author | | Joutoku, Zenta Browse this author | | Matsubara, Shinji Browse this author | | Iwasaki, Koji Browse this author →KAKEN DB | | Matsuoka, Masatake Browse this author →KAKEN DB | | Onodera, Tomohiro Browse this author →KAKEN DB | | Momma, Daisuke Browse this author →KAKEN DB | | Inoue, Masayuki Browse this author | | Yagi, Tomonori Browse this author | | Iwasaki, Norimasa Browse this author →KAKEN DB | | Yasuda, Kazunori Browse this author →KAKEN DB |
| Keywords: | high tibial osteotomy | | open wedge | | patellofemoral joint | | osteoarthritis |
| Issue Date: | 1-Jul-2022 |
| Publisher: | SAGE Publications |
| Journal Title: | American journal of sports medicine |
| Volume: | 50 |
| Issue: | 9 |
| Start Page: | 2439 |
| End Page: | 2452 |
| Publisher DOI: | 10.1177/03635465221104708 |
| Abstract: | Background: Recent studies have reported that medial opening wedge (OW) high tibial osteotomy (HTO) induces patella baja, resulting in degenerative changes in the patellofemoral joint. We have developed an inverted V-shaped (iV) HTO, which is classified as a neutral wedge osteotomy. Hypotheses: The study hypotheses were as follows: (1) patellar height, posterior tibial slope, and tibial length will not change between pre- and postoperative evaluations after iV-HTO; (2) the lateral shift ratio of the patella and the distance between the tibial tubercle and the trochlear groove may be significantly decreased after iV-HTO. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 191 patients (220 knees) who underwent HTO for medial osteoarthritis were enrolled retrospectively in this study: 107 knees underwent OW-HTO and 113 knees underwent iV-HTO. Clinical and radiological evaluations were performed before and at least 3 years after surgery. Results: Postoperatively, the mean Caton-Deschamps ratio was significantly decreased (P < .0001) from 0.95 to 0.79 in the OW group, while there were no significant changes in the iV group. The mean posterior tibial slope was significantly increased (P < .0001) from 8.5 degrees to 10.5 degrees in the OW group, while there were no significant differences in the iV group. Although the entire leg length was significantly increased (P < .0003) in both groups after HTO, there were no significant differences in tibial length between the pre- and postoperative periods in the iV group. Regarding the congruity of the patellofemoral joint, the mean lateral shift ratio did not significantly change in the OW group, whereas it was significantly decreased (P = .0012) from 11.5% to 8.8% in the iV group. The mean tibial tubercle-trochlear groove distance was significantly decreased (P < .0001) from 12.8 to 9.7 mm in the iV group, while it was significantly increased in the OW group (P < .0001). Concerning the clinical outcome, the Japanese Orthopaedic Association (JOA) and Lysholm knee scores at final follow-up (OW vs iV: JOA, 91.2 vs 90.1; Lysholm, 92.5 vs 89.0) were significantly increased (P < .0001) as compared with the preoperative values (OW vs iV: JOA, 68.3 vs 66.8; Lysholm, 67.9 vs 61.0). Conclusion: Patellar height, posterior tibial slope, and tibial length did not change after the iV-HTO, while they were significantly changed after the OW-HTO. Although the preoperative degrees of varus knee and patellofemoral osteoarthritis were more severe in the iV group than the OW group, the iV-HTO led to altered patellofemoral joint congruity. |
| Rights: | Kondo E, Yabuuchi K, Joutoku Z, et al. Effect of the Inverted V-Shaped Osteotomy on Patellofemoral Joint and Tibial Morphometry as Compared With the Medial Opening Wedge High Tibial Osteotomy. The American Journal of Sports Medicine. 2022;50(9):2439-2452. Copyright © 2022 (Copyright Holder). DOI: 10.1177/03635465221104708 |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/86676 |
| 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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Submitter: 近藤 英司
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