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Study shows increased internal rotation of the distal tibia after open-wedge HTO
In this study of 35 patients who underwent biplane medial open-wedge high tibial osteotomy, researchers found an unintended tendency to increase internal rotation of the distal tibial, which was significantly associated with the tuberosity osteotomy angle and the opening width. Investigators performed a preoperative and a postoperative radiographic evaluation 3 days after the surgery to determine the hip-knee-ankle angle, medial proximal tibial angle, posterior tibial slope, distal tibial rotation and tuberosity osteotomy angle.
Results showed the mean preoperative distal tibial rotation for external rotation was 27.8° and postoperatively it was 24.2°. Investigators noted the mean difference from preoperative hip-knee-ankle angle to the postoperative measure was 11.8°. Investigators also found the mean difference in the medial proximal tibial angle from the preoperative measure to the postoperative measure was 10.1°. Posterior tibial slope was 10.7° preoperatively and 11.3° postoperatively. The mean tuberosity osteotomy angle was 19.1°.
According to researchers, the change in distal tibial rotation was not associated with changes in the hip-knee-ankle angle, medial proximal tibial angle and posterior tibial slope. Results from the multiple linear regression analysis showed the tuberosity osteotomy angle and the opening width were statistically significant predictors for distal tibial rotation changes after open-wedge high tibial osteotomy. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.
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Jang K, et al. J Arthroplasty. 2016;doi:10.1016/j.arth.2015.08.010.