CHANGES OF KNEE JOINT AND ANKLE JOINT ORIENTATIONS AFTER MEDIAL OPEN WEDGE HIGH TIBIAL OSTEOTOMY

Abstract

Background: Varus knee is a common deformity of the knee joint, which is usually accompanied by osteoarthritis, especially the medial compartment. High tibial osteotomy is a good solution for varus knee by transferring the load from the medial compartment to the more healthy lateral compartment slowing the progression of osteoarthritis. Objectives: To assess the changes of knee joint and ankle joint orientations after medial open wedge high tibial osteotomy. Patients and Methods: This prospective study was done on a consecutive sample of 20 patients who were admitted to Al-Azhar University Hospital during the period between October 2017 and October 2019 with varus knee. Exclusion criteria were severe osteoarthritis, periarticular fractures, cruciate ligament insufficiency, previous operations of the knee and inflammatory arthritis. All patients had undergone medial open wedge high tibial osteotomy after giving informed consents. Patients were followed up for 6 months. Results: Preoperatively mTFA was -9.33°, TPI was -6.38°, KJLO was -0.40°, AJLO was 7.6°, PH was 0.93 and PTS was 7.53°. Their postoperative measurements changed to 1.75°, 2.5°, 2.03°, -0.03°, 0.86 and 8.93° respectively. Conclusion: After medial open wedge high tibial osteotomy, posterior tibial slope and tibial plateau inclination increased, patellar height decreased, ankle joint orientation line became more parallel to the ground and knee joint orientation line became more laterally tilted.