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Coronal tibiofemoral subluxation is correlated to correction angle in medial opening wedge high tibial osteotomy

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to analyse the change in coronal tibiofemoral (CTF) subluxation after high tibial osteotomy and to determine demographic variables associated with CTF subluxation. The change in CTF subluxation was hypothesised to be associated with the magnitude of correction of lower limb alignment and medial proximal tibial angle (MPTA).

Methods

A total of 103 consecutive knees in 86 patients who underwent medial opening wedge high tibial osteotomy for symptomatic medial compartment knee osteoarthritis were retrospectively analysed. The normal %CTF subluxation value, which was defined as a subluxation of the proximal tibia relative to the distal femur on the lateral edge of the femorotibial joint, was determined from 60 normal knees. The association between CTF subluxation and the Knee Society Score (KSS) and radiographic parameters was examined.

Results

The normal range for %CTF subluxation was defined as − 1.8 to 5.6%. Following osteotomy, Δ%CTF subluxation reduced from a mean of 4.5% (− 12.1 to − 4.6%) to 0.7% (− 6.8 to 8.2%), resulting in a decrease in lateral tibiofemoral subluxations concomitant with an increase in medial subluxations. The reduction in CTF subluxation correlated moderately with MPTA change (r = − 0.454, p < 0.001) and weakly with preoperative lower limb alignment as represented by hip–knee–ankle angle and %weight-bearing line. Multivariate regression analysis showed that ΔMPTA was a significant contributor of Δ%CTF subluxation.

Conclusion

Osteotomy reduced CTF subluxation, which was correlated with MPTA change. Postoperative MPTA should be considered during surgical planning, and a postoperative MPTA of approximately 93.5° may be an appropriate target to reduce CTF subluxation by obtaining normal CTF congruency.

Level of evidence

Level IV therapeutic, retrospective, cohort study.

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Funding

No external source of funding was used.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, Gifu, 501-1194, Japan

    Hiroyasu Ogawa, Kazu Matsumoto & Haruhiko Akiyama

  2. Department of Advanced Joint Reconstructive Surgery, Gifu University Graduate School of Medicine, Gifu, Japan

    Hiroyasu Ogawa

Authors
  1. Hiroyasu Ogawa
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  2. Kazu Matsumoto
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  3. Haruhiko Akiyama
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Correspondence to Kazu Matsumoto.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in this study.

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Ogawa, H., Matsumoto, K. & Akiyama, H. Coronal tibiofemoral subluxation is correlated to correction angle in medial opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 26, 3482–3490 (2018). https://doi.org/10.1007/s00167-018-4948-9

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  • DOI: https://doi.org/10.1007/s00167-018-4948-9

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