Open wedge high tibial osteotomy linked with patellofemoral joint degeneration
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According to published results, open wedge high tibial osteotomy with a small correction angle may be associated with degeneration of articular cartilage within the patellofemoral joint.
Researchers retrospectively analyzed data on 37 knees that underwent open wedge high tibial osteotomy (HTO) and 38 knees that underwent hybrid closed wedge HTO for medial knee osteoarthritis from August 2017 to November 2019. According to the study, open wedge HTO was indicated for corrections of less than 10 degrees, whereas hybrid closed wedge HTO was indicated for corrections of more than 10 degrees.
Researchers used T2 MRI mapping to evaluate changes in patellar cartilage at preoperative and 6-month postoperative timepoints. They also analyzed patellar tilt, patellar height and lateral shift ratio, according to the study.
Arthroscopically, researchers found no significant changes in degeneration of articular cartilage within the patellofemoral joint in either group. However, they noted open wedge HTO was associated with significant increases in mean T2 value of medial and middle facets, whereas no significant changes were observed in the hybrid closed wedge HTO group at 6 months.
Researchers also found patellar tilt and patellar height decreased in the open wedge HTO group, whereas patellar height increased in the hybrid closed wedge HTO group at 6 months. They noted lateral shift ratio decreased in both groups.
“In the case of open wedge HTO, even a minor correction may result in subsequent deleterious patellofemoral joint effects, suggesting that other techniques may need to be considered, or the technique should be modified,” the researchers wrote in the study.
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