The Coronal Plane High Tibial Osteotomy. Part II: A Comparison of Axial Rotation with the Opening Wedge High Tibial Osteotomy

Abstract

The amount of axial rotation in the tibia caused by high tibial osteotomy is relatively unknown. The authors hypothesize that the coronal plane high tibial osteotomy, a novel technique used to treat varus malalignment, alters the axial rotation of the tibia less than the opening wedge high tibial osteotomy. Eight, embalmed, stripped cadaveric tibia-fibula constructs with intact interosseous membranes were randomized to either opening wedge or coronal plane high tibial osteotomies. Sequential valgus corrections of 5 degrees, 10 degrees, and 15 degrees were performed. The Qualisys Track Manager motion capture system was used to measure axial rotation. Student's t test was used to compare axial rotation between the two groups. A p value of 0.05 was determined to be significant. The coronal plane technique produced rotations about the tibial axis that were statistically significantly smaller than those of the opening wedge technique for all correction angles (1.2 degrees internal rotation (IR) vs 16 degrees external rotation (ER), respectively, at 5 degrees correction; p = 0.02) (3.5 degrees IR vs 21.2 degrees ER at 10 degrees correction; p = 0.04) (4.5 degrees IR vs 23.0 degrees ER at 15 degrees correction; p = 0.01). The coronal plane high tibial osteotomy alters axial rotation of the tibia significantly less than the opening wedge high tibial osteotomy.