Abstract
Objective To explore the effect of age stratification on patellar height after single-plane high tibial osteotomy of the distal tibial tuberosity (DTT-HTO). Methods A retrospective analysis was performed on 110 knee joints undergoing DTT-HTO. Patients were divided into three groups according to age: under 60 years old, 28 cases; 60 to 70 years old, 61 cases; and over 70 years old, 21 cases. All patients were followed up for no less than 12 months, and at each follow-up, short-leg radiographs and whole-leg radiographs were taken. The values of the Caton-Deschamps index (CDI) and Blackburne-Peel index (BPI) of single-short-leg radiographs and the femoral-tibial angle (FTA) and weight-bearing line ratio (WBLR) of whole-leg radiographs were measured before and at the last follow-up. The Lysholm score before and at the last follow-up and the visual analogue scale (VAS) score before and 3 days after surgery and at the last follow-up were calculated. The frequency of classification of the normal-height patella, patella alta, and patella baja before and after surgery was recorded. Results There were no significant differences in CDI and BPI preoperatively or postoperatively among the three groups (P > 0.05), and there were no statistically significant differences in FTA and WBLR. There were no significant differences in CDI, BPI, FTA, or WBLR between the three groups before and after the operation (P > 0.05). The Lysholm score increased from 48.84 ± 10.10 before surgery to 91.96 ± 3.082 after surgery (P < 0.05); the VAS score decreased from 8.23 ± 0.99 before surgery to 1.93 ± 0.953 at 3 days after surgery and 1.07 ± 0.53 at the last follow-up (P < 0.01). No significant difference was observed in the incidence of each patellar height classification between the three groups preoperatively and postoperatively. Conclusion Patellar height is not influenced by DTT-HTO. The age of patients is not a limiting factor for the selection of this surgical procedure. Without affecting the height of the patella, DTT-HTO can effectively reduce pain in the knee joint, restore the function of the knee joint, and delay the progression of patellar arthritis.
Highlights
High tibial osteotomy is one of the surgical methods for treating medial compartment knee osteoarthritis
Traditional HTO is divided into closing-wedge high tibial osteotomy (CWHTO) and open-wedge high tibial osteotomy (OWHTO), and both procedures can effectively correct the coronal weight-bearing line of the knee joint, transfer the lower limb alignment from the medial compartment of the knee joint to the lateral compartment, increase the stress area of the tibiofemoral joint, and reduce the pressure of the medial compartment to relieve medial compartment knee pain and help patients recover walking function [1–13]
Exclusion criteria are as follows: (1) rotational angles existing between the medial femoral condyle and the lateral femoral condyle in one of the lateral radiographs and (2) patients suffering from types of arthritis other than knee osteoarthritis (KOA)
Summary
High tibial osteotomy is one of the surgical methods for treating medial compartment knee osteoarthritis. Traditional HTO is divided into closing-wedge high tibial osteotomy (CWHTO) and open-wedge high tibial osteotomy (OWHTO), and both procedures can effectively correct the coronal weight-bearing line of the knee joint, transfer the lower limb alignment from the medial compartment of the knee joint to the lateral compartment, increase the stress area of the tibiofemoral joint, and reduce the pressure of the medial compartment to relieve medial compartment knee pain and help patients recover walking function [1–13]. The value of E for bone is 14 GPa. HTO can affect the postoperative bone structure of the patellofemoral joint, resulting in patella alta or patella baja compared to the preoperative situation. Measurement methods [15] such as CDI [16] and BPI [16] are often used to test whether the height of the patella changes
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