Does proximal tibial osteotomy with a novel osteotomy system obtain coronal plane correction without affecting tibial slope and patellar height?

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Web End = Knee Surg Sports Traumatol Arthrosc (2015) 23:34873493 DOI 10.1007/s00167-014-3187-y

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Web End = Does proximal tibial osteotomy with a novel osteotomy system obtain coronal plane correction without affecting tibial slope and patellar height?

Andrew J. Blackman Aaron J. Krych William M. Engasser Bruce A. Levy Michael J. Stuart

Received: 26 March 2014 / Accepted: 10 July 2014 / Published online: 14 August 2014 Springer-Verlag Berlin Heidelberg 2014

undercorrection of 10.6 % of the target WBL ratio was seen in the group as a whole, although secondary analysis of these results indicated that patients with medial compartment osteoarthritis and/or preoperative mechanical axis of >6 varus accounted for the majority of the cases of undercorrection.

Level of evidence Retrospective case series, Level IV.

Keywords Proximal tibial osteotomy Tibial slope

Patellar height Genu varum

Introduction

Medial opening wedge proximal tibial osteotomy (PTO) is a well-established treatment option for patients with genu varum with a variety of concomitant diagnoses, including medial compartment osteoarthritis, ligamentous instability, osteonecrosis, and chondral or osteochondral defect, amongst others [21, 23]. Historically, medial opening wedge osteotomy techniques have used conventional plating [21], precontoured locking plates [9, 11], and plates with xed spacer blocks (e.g. Puddu plates) [5, 11, 15, 17], as well as xation strategies [18, 21, 23]. In addition to correcting coronal plane deformities, opening wedge osteotomy with these techniques has been noted to have unintended effects on both tibial slope [5, 9, 10, 15, 17, 18] and patellar height [2, 5, 9, 10, 15, 17, 24].

Recently, modern instrumentation and implant systems for performing medial opening wedge osteotomy have been introduced. A recent publication demonstrated equivalence between a modern osteotomy system and earlier generation osteotomy systems in terms of complications, radiographic union, and clinical outcomes at 12 months in patients with genu varum and medial compartment osteoarthritis [11].

Abstract

Purpose To determine changes in tibial slope, patellar height, and coronal plane alignment after medial opening wedge proximal tibial osteotomy (PTO) using a modern osteotomy system.

Methods Patients undergoing medial opening wedge PTO for any indication with follow-up until radiographic union...