Abstract
The aim of this study is to examine the short-term effects of patellar tendon advancement on the proximal tibial slope in the skeletally immature patient. A retrospective, non-randomized, comparative cohort design was used. Koshino indices and tibial slopes were assessed pre-operatively and post-operatively and compared with age- and sex-matched controls. Nine children with 17 patellar tendon advancements were analyzed for changes in Koshino indices. Of these 17 tibiae, radiographs on changes in tibial slope were available for 16 tibiae which were also compared with controls. Children aged <11years had a greater initial posterior tibial slope (69.8°±3.5°) than age-matched controls (80.3°±2.7°). A decrease in posterior slope was seen in these younger patients (average change 10.3°±4.8°) at an average of 1.6years of follow-up. Of the nine apophyses in children aged <11years of age, seven had undergone premature closure. Patellar tendon advancement appears to have an unreported effect on the proximal tibial growth in the young patient (<11years old). These patients appear to be susceptible to apophyseal closure, resulting in subsequent loss of posterior tibial slope. Surgeons should be aware of this effect and monitor younger patients with radiographs if performing this procedure.
Highlights
The normal proximal tibia has a posterior slope from 7° to 15° in the adult knee [1,2,3]
Nine children with 17 patellar tendon advancements were analyzed for changes in Koshino indices
Of these 17 tibiae, radiographs on changes in tibial slope were available for 16 tibiae which were compared with controls
Summary
The normal proximal tibia has a posterior slope from 7° to 15° in the adult knee [1,2,3]. It may be speculated that the more posteriorly located weightbearing axis in patients with flexion contractures can add to the increased posterior slope of the tibia by adding a compressive load to the posterior growth plate. This would result in growth retardation manner similar to that seen in other pathologic states, such as Blount’s disease, where excessive mechanical loading results in varus angular deformities about the knee [5, 6].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
