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Comparative Study
. 2019 Sep 4;20(1):409.
doi: 10.1186/s12891-019-2764-0.

Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Takashi Higuchi  1 , Hironobu Koseki  2   3 , Akihiko Yonekura  4 , Ko Chiba  4 , Yusuke Nakazoe  5 , Shinya Sunagawa  1 , Chieko Noguchi  4 , Makoto Osaki  4
Affiliations
Comparative Study

Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Takashi Higuchi et al. BMC Musculoskelet Disord. .

Abstract

Background: The purpose of this study was to compare radiological features between high tibial osteotomy (HTO) and tibial condylar valgus osteotomy (TCVO), in order to define the radiological indication criteria for TCVO.

Methods: Thirty-two cases involving 35 knees that had undergone HTO and the same number that had undergone TCVO for knee osteoarthritis were retrospectively evaluated. Characteristics of both groups did not differ significantly. Lower limb alignment, bone morphology, joint congruity, and joint instability were measured in standing full-length leg and knee radiographs obtained before and after surgery.

Results: Radiological features in the TCVO group included greater frequencies of advanced knee OA grade, varus lower limb malalignment, depression of the medial tibial plateau, and varus-valgus joint instability compared to the HTO group before surgery. However, tibial morphology, alignment of the lower limb, and joint instability improved to comparable levels after surgery in both groups.

Conclusions: TCVO appears preferable in cases with advanced knee OA, destroyed or inclined medial tibial plateau, widened and subluxated lateral joint, and high varus-valgus joint instability.

Keywords: High tibial osteotomy; Knee osteoarthritis; Tibial condylar valgus osteotomy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Anteroposterior radiographs of full-length legs in a standing position (a) before and (b) after TCVO. The L-shaped osteotomy is opened and fixed with TomoFix™ plate. The opened gap space was filled with granular β-TCP
Fig. 2
Fig. 2
a: Percentage of mechanical axis (%MA), b: femorotibial angle (FTA), and c: hip-knee-ankle angle (HKA angle) were measured to evaluate leg alignment
Fig. 3
Fig. 3
a: Mechanical lateral distal femoral angle (mLDFA) and b: medial proximal tibial angle (MPTA) were measured to evaluate the morphologies of the distal femur and proximal tibia
Fig. 4
Fig. 4
a: Medial tibial plateau depression (MTPD) and b: Posterior proximal tibial angle (PPTA) were measured to evaluate the morphology of the tibial plateau
Fig. 5
Fig. 5
Joint line convergence angle (JLCA) was measured to evaluate knee joint congruity
Fig. 6
Fig. 6
Varus and valgus stress angle. a: Varus and b: valgus stress were applied and the total amplitude of varus- and valgus-stress angle was identified as the laxity angle
See this image and copyright information in PMC

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