ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Alignment changes after open-wedge high tibial osteotomy result in offloading in the patellofemoral joint: a SPECT/CT analysis.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 17 citations in OpenAlex.
- Sagittal alignment and patellofemoral consequences of open wedge high tibial osteotomy: a comparative radiological and gait analysis of supratubercle and distal tibial tuberosity techniques.Journal of orthopaedic surgery and research · 2026Article
- Medial open-wedge high tibial osteotomy alters sagittal tibial tubercle-trochlear groove distance.Archives of orthopaedic and trauma surgery · 2026Article
- Influence of Alignment Changes in Different Planes During Supra-Tubercular Biplanar Medial Opening Wedge High Tibial Osteotomy on Tibial Tubercle-Trochlear Groove Distance.Orthopaedic surgery · 2025Article
- Digging into the Cause of Abnormal Patellar Kinematics After Open-Wedge High Tibial Osteotomy via a Quantitative Study on In Vivo Soft Tissue Functional Changes.Bioengineering (Basel, Switzerland) · 2025Article
- Increased medial tibial slope is a possible risk factor for patellar cartilage lesions.Journal of experimental orthopaedics · 2024Article
- Effects of different hinge positions on tibial rotation in uniplanar medial opening wedge high tibial osteotomy with three-dimensional tibial models.Frontiers in surgery · 2024Article
- TT-TG distance decreases after open wedge distal femoral varization osteotomy in patients with genu valgum & patellar instability. A pilot 3D computed tomography simulation study.BMC musculoskeletal disorders · 2023Article
- Serial Quantitative Assessment of Load Redistribution After Medial Open-Wedge High Tibial Osteotomy.Orthopaedic journal of sports medicine · 2023Article
- Precise Patellar Tendon Insertion Protection and Osteotomy Surface Advantage of Transtibial Tuberosity-High Tibial Osteotomy.Orthopaedic surgery · 2023Article
- Patellar Height after High Tibial Osteotomy of the Distal Tibial Tuberosity: A Retrospective Study of Age Stratification.Computational and mathematical methods in medicine · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe patellofemoral (PF) joint may be adversely affected by medial open-wedge high tibial osteotomy (OWHTO). This study aimed to evaluate the PF compartmental changes using combined single-photon emission computed tomography (SPECT) and conventional computed tomography (CT) after OWHTO to provide clinical guidance regarding the PF joint pressure and force.
methodsPatients with medial osteoarthritis and varus malalignment > 5° were treated using OWHTO. Patients with a minimum 2-year follow-up were included in the study. The patellar positions were evaluated based on the radiographic parameters. The changes in chondral lesions during second-look arthroscopic examination were evaluated, and the PF joint arthritis grade was recorded on patellar Merchant radiographs using Kellgren-Lawrence classification. The PF compartmental changes according to SPECT/CT analysis after OWHTO were evaluated in all patients. The scintigraphic uptake was graded on four scales. Patients were divided into improved and unimproved groups according to the PF compartmental grade using the SPECT/CT uptake grading system.
resultsAt a mean follow-up period of 47.0 months (range 25-74 months), the mean mechanical femorotibial angle changed significantly from varus 6.3° (range 5-12°) to valgus 2.6° (range 0-8°); p < 0.001) postoperatively. The radiological parameters presenting patellar positions, including the tibial slope, patellar convergence angle, and lateral tilt angle, did not change significantly between the preoperative values and the 2-year follow-up values. The mean patellar height significantly decreased (0.07 ± 0.14, p = 0.001 according to the Blackburn-Peel index and 0.32 ± 0.23, p < 0.001 using the modified Insall-Salvati ratio). The average tibial tubercle to trochlear groove (TT-TG) distance significantly decreased from 14.1 to 12.2 mm (p < 0.001). The Q angle also significantly decreased from 9.8
conclusionAlignment correction by OWHTO result in PF compartment offloading and should be considered when identifying the surgical indications for OWHTO. LEVEL OF EVIDENCE: Therapeutic, Level IV.
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