[Changes in patellar height and tibia inclination angle following open-wedge high tibial osteotomy]

Abstract

Objectives: We investigated changes in patellar height and tibial inclination angle after open-wedge high tibial osteotomy and the effect of these changes on patient satisfaction.

Methods: The study included 18 knees of 16 patients (4 males, 12 females; mean age 55 years; range 44 to 66 years) who underwent open-wedge proximal tibial osteotomy with autogenous bone graft and medial plate for medial compartment gonarthrosis. Nine knees (50%) had Ahlbäck grade I, eight knees (44.4%) had grade II, and one knee (5.6%) had grade III osteoarthritis. Pre- and postoperatively, femorotibial angle, tibial inclination angle, and patellar height were measured according to the Bauer, Harvey-Moore, and Blackburne-Peel methods, respectively. Clinical evaluations were made using the Lysholm-Gillquist score. Patient satisfaction was questioned with a 10-point scale. The mean follow-up was 54.2 months (range 25 to 96 months).

Results: Postoperatively, the mean correction of the femorotibial angle was 13.6 degrees (p<0.05), and the mean increase in the tibial inclination angle was 2.9 degrees (p<0.05). Fifteen knees (83.3%) exhibited a significant decrease in patellar height by a mean of 15% (p<0.05). The mean Lysholm-Gillquist score increased from preoperative 61 to 86 at the latest follow-up (p<0.05). The results were excellent in 11 knees (61.1%), good in six knees (33.3), and poor in one knee (5.6%). The mean patient satisfaction score was 8.1 (range 5 to 10). Changes in the femorotibial angle and Lysholm-Gillquist score were significantly correlated with patient satisfaction (p<0.05). Three patients had nonunion, perioperative intra-articular fracture, and superficial wound infection, respectively.

Conclusion: Changes in the tibial inclination angle and patellar height following open-wedge tibial osteotomy do not have an adverse effect on short-term patient satisfaction.