ArticleJournal of experimental orthopaedics2026
Three-dimensional computed tomography-based comparison reveals divergent patellar and tibial tubercle behaviour between lateral closed-wedge and medial open-wedge high tibial osteotomy.
Article in Journal of experimental orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: This study aimed to compare three-dimensional patellar and tibial positional changes after medial open-wedge high tibial osteotomy (MOWHTO) and lateral closed-wedge high tibial osteotomy (LCWHTO) using computed tomography. Methods: This retrospective comparative cohort study included 18 patients who underwent high tibial osteotomy for medial knee osteoarthritis (9 MOWHTO, 9 LCWHTO). LCWHTO was selected for patients with patellofemoral joint degeneration, patellofemoral cartilage injury, anterior knee pain or correction angle ≥10°; MOWHTO was selected for the remaining patients. Full-length lower-limb computed tomography scans were obtained preoperatively and at 1 year postoperatively. Displacement and rotation of the patella and distal tibial fragment were quantified in the anterior-posterior, medial-lateral and proximal-distal directions and in the internal-external, varus-valgus and flexion-extension rotations and compared between groups. Results: In the MOWHTO group, the patella shifted distally (1.2 ± 1.9 mm) with internal (3.0° ± 1.9°) and valgus (1.9° ± 1.5°) rotation, whereas in the LCWHTO group it shifted proximally (1.6 ± 1.9 mm) with minimal rotation (proximal-distal displacement, Conclusion: MOWHTO and LCWHTO produced distinctly different three-dimensional positional changes of the patella and distal tibial fragment. These positional findings provide a mechanistic basis for individualised surgical decision-making, but their direct impact on PF cartilage status and long-term outcomes requires confirmation in future studies. Level of Evidence: Level III, retrospective comparative cohort study.
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