Omer Ozel1, Bulent Yucel2, Serhat Mutlu3, Osman Orman4, Harun Mutlu5. 1. Department of Orthopaedics, Istanbul Baskent University Hospital, Istanbul, Turkey. 2. Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Atakent Mahallesi, Turgut Ozal Caddesi, No: 1, Kucukcekmece, 34303, Istanbul, Turkey. 3. Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Atakent Mahallesi, Turgut Ozal Caddesi, No: 1, Kucukcekmece, 34303, Istanbul, Turkey. serhatmutlu@hotmail.com. 4. Department of Orthopaedics, Silivri Government Hospital, Istanbul, Turkey. 5. Department of Orthopaedics, Taksim Training and Research Hospital, Istanbul, Turkey.
Abstract
PURPOSE: In this study, postoperative changes in the posterior tibial slope angle and clinical outcomes following open-wedge high tibial osteotomy were evaluated. METHODS: This study included 39 knees (18 left, 21 right) of 35 patients (three male, 32 female; median age, 53 years; age range 37-64 years) with symptomatic isolated medial joint osteoarthritis who underwent open-wedge high tibial osteotomy and fixation with a Puddu plate. The patients were clinically assessed according to the Lysholm knee score, a visual analogue pain scale, and a patient satisfaction questionnaire. Radiological assessment was made according to the changes in the posterior tibial slope angle and the correlation between these changes and clinical signs. The median follow-up period was 11 years (range 7-14 years). RESULTS: Significant improvements were observed in the preoperative and postoperative clinical scores of the Lysholm knee scale, visual analogue pain scale, and patient satisfaction questionnaire (p < 0.05). Radiological assessment showed that the posterior tibial slope angle was significantly higher during the postoperative and follow-up periods (p 0.05). There was no correlation between the postoperative Lysholm scores and the increase in the posterior tibial slope angle (p = n.s.). CONCLUSIONS: We conclude that both the conventional Puddu plate design and its anteromedial plate placement are what increase the tibial slope after an opening-wedge proximal tibial osteotomy. Therefore, current new plate design may help preserve the posterior tibial slope angle. LEVEL OF EVIDENCE: IV.
PURPOSE: In this study, postoperative changes in the posterior tibial slope angle and clinical outcomes following open-wedge high tibial osteotomy were evaluated. METHODS: This study included 39 knees (18 left, 21 right) of 35 patients (three male, 32 female; median age, 53 years; age range 37-64 years) with symptomatic isolated medial joint osteoarthritis who underwent open-wedge high tibial osteotomy and fixation with a Puddu plate. The patients were clinically assessed according to the Lysholm knee score, a visual analogue pain scale, and a patient satisfaction questionnaire. Radiological assessment was made according to the changes in the posterior tibial slope angle and the correlation between these changes and clinical signs. The median follow-up period was 11 years (range 7-14 years). RESULTS: Significant improvements were observed in the preoperative and postoperative clinical scores of the Lysholm knee scale, visual analogue pain scale, and patient satisfaction questionnaire (p < 0.05). Radiological assessment showed that the posterior tibial slope angle was significantly higher during the postoperative and follow-up periods (p 0.05). There was no correlation between the postoperative Lysholm scores and the increase in the posterior tibial slope angle (p = n.s.). CONCLUSIONS: We conclude that both the conventional Puddu plate design and its anteromedial plate placement are what increase the tibial slope after an opening-wedge proximal tibial osteotomy. Therefore, current new plate design may help preserve the posterior tibial slope angle. LEVEL OF EVIDENCE: IV.
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