Coronal subluxation of the proximal tibia relative to the distal femur after opening wedge high tibial osteotomy

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• 作者：Yasushi Akamatsu ; ^{akamatsu@yokohama-cu.ac.jp} ; Satoshi Ohno ; Hideo Kobayashi ; Yoshihiro Kusayama ; Ken Kumagai ; Tomoyuki Saito
• 关键词：Coronal subluxation ; Radiograph ; Opening wedge high tibial osteotomy ; Knee ; Femorotibial joint
• 刊名：The Knee
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：24
• 期：1
• 页码：70-75
• 全文大小：366 K
• 卷排序：24

文摘

The coronal subluxation of the proximal tibia relative to the distal femur is a common radiological finding in patients with knee osteoarthritis. The purpose was to evaluate whether the coronal subluxation was corrected after opening wedge high tibial osteotomy (OWHTO), and whether this subluxation was one cause of inconsistency between the actual and predicted alignments (correction loss).MethodsFifty-one patients (55 knees) were treated with OWHTO. The change of location between the intersection points of the femoral and tibial axes on the tibial plateau (subluxation-C), the change of location between the lines through the most lateral points of the lateral femoral and tibial condyles (subluxation-L), and joint space angle (JSA) were compared in standing knee radiographs before and one year after OWHTO. The subluxation-C and subluxation-L were converted to a percentage of the tibial plateau width.ResultsThe mean subluxation-C of 6.5% before OWHTO significantly increased to a mean subluxation-C of 7.3% one year after OWHTO. The mean subluxation-L of 6.3% and JSA of 4.5° before OWHTO significantly decreased to a subluxation-L of 1.8% and JSA of 3.3° one year after OWHTO. The change in subluxation-L correlated with the change in femorotibial angle and correction loss (r = 0.634, P < 0.001 and r = 0.463, P < 0.001, respectively).ConclusionThe proximal tibia shifted medially relative to the distal femur after OWHTO. This medial shift correlated with the correction loss. The coronal subluxation might be one cause of correction loss.