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L’articulation fémoro-patellaire n’est pas altérée cliniquement après ostéotomie tibiale de valgisation par ouverture médiale - 05/05/21

The patellofemoral joint does not deteriorate clinically after open-wedge high tibial osteotomy

Doi : 10.1016/j.rcot.2021.03.032 
Hee-June Kim a, Ji-Yeon Shin b, Hyun-Joo Lee a, Kyeong-Hyeon Park a, Chul-Hee Jung a, Hee-Soo Kyung a,
a Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea 
b Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea 

Corresponding author at: Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongduk-Ro Jung-gu, Daegu 41944, Korea.Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital130 Dongduk-Ro Jung-guDaegu 41944Korea
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 05 May 2021

Abstract

Background

After high tibial osteotomy (HTO), the loading of the lateral compartment can be increased. Moreover, the change of patellar height may adversely affect the patellofemoral joint and functional outcomes.

Hypothesis

We hypothesized that the cartilage of the lateral compartment and patellofemoral joint would worsen after open-wedge HTO and the overcorrection of HTO could worsen the cartilage state of the patellofemoral joint. We evaluated the cartilage status and clinical results after medial open-wedge HTO and the factors affecting the outcomes.

Materials and methods

From 2011 to 2018, 49 patients who had a mean age of 54.9 years and who underwent medial open-wedge HTO were selected. Plate removal was performed at a mean of 37.0 (range, 13–89) months after HTO, whereas diagnostic arthroscopy was performed during medial open-wedge HTO and plate removal. The cartilage status of each joint and the clinical results, including the Hospital for Special Surgery (HSS) score, Knee Society knee score (KS) and function score (FS), and patellar score, were compared. We evaluated the postoperative changes in the cartilage status and clinical scores. Additionally, we evaluated whether the postoperative correction degree could affect the clinical results.

Result

After medial open-wedge HTO, the patellar height decreased. There was no change in the cartilage at the patellar and femoral trochlear groove. The HSS score, KS, and FS improved, but the patellar score remained unchanged. In the overcorrection group, the cartilage status significantly deteriorated at the lateral tibia condyle as compared with that in the undercorrection group. Higher preoperative clinical scores were associated with less postoperative improvement.

Discussion and conclusion

The outcomes in the patellofemoral joint, including the cartilage condition and clinical scores, did not change after open-wedge HTO, despite patellar infera. Additionally, they were not influenced by the correction degree. Higher preoperative clinical scores were associated with less postoperative improvement.

Level of evidence

IV; Retrospective study.

Le texte complet de cet article est disponible en PDF.

Keywords : Medial joint loading, Cartilage condition, Correction, High tibial osteotomy



 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.


© 2021  Publié par Elsevier Masson SAS.
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