Influence de l’augmentation de la pente tibiale sur l’état du ligament croisé antérieur après ostéotomie tibiale d’ouverture de valgisation dans une population de genou à ligament croisé antérieur intact - 19/09/19
Effect of increased posterior tibial slope on the anterior cruciate ligament status in medial open wedge high tibial osteotomy in an uninjured ACL population
, Haruhiko Akiyama aAbstract |
Purpose |
The purpose of this study was to clarify the relationship between posterior tibial slope angle (PTSA) and anterior cruciate ligament (ACL) status in medial open wedge high tibial osteotomy (OWHTO). Our hypothesis was that even though OWHTO may improve anteroposterior laxity of the knee, an increase in PTSA after OWHTO would be associated with ACL degeneration.
Methods |
Seventy-five patients treated with OWHTO were retrospectively analyzed. PTSA were evaluated radiographically pre- and postoperatively. The ACL was evaluated during the index arthroscopy at the time of OWHTO and a second-look arthroscopy during the plate removal, and scored from 1 (normal ACL) to 4 (complete tear). An anterior tibial translation (ATT) test was performed.
Results |
The mean time period from the index to second-look arthroscopy was 15.0±4.4 months. PTSA significantly increased from 5.3±3.4° preoperatively to 7.5±4.0° postoperatively (p<0.001). The average ACL score significantly increased from 1.9±0.5 at the index arthroscopy to 2.2±0.5 at the second-look arthroscopy (p=0.0025). The average ATT on the operated side significantly decreased from 7.1±2.6mm preoperatively to 5.3±2.3mm at the second look arthroscopy (p<0.0001). There was a significant positive correlation between the increase in PTSA and the change of ACL grade (Correlation coefficient (r)=0.221, p<0.05).
Conclusion |
Even though OWHTO reduces anteroposterior knee laxity, an increase in PTSA is associated with ACL degeneration. It is important for the surgeon to avoid an increase in PTSA during the procedure to prevent ACL degeneration after OWHTO.
Level of Evidence |
IV, therapeutic retrospective case series.
Le texte complet de cet article est disponible en PDF.Keywords : High tibial osteotomy, Open wedge, Anterior cruciate ligament, Posterior tibial slope, Anterior tibial translation
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 105 - N° 6
P. 700 - octobre 2019 Retour au numéro
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