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Cartilage, tibial slope and HTO
145
Results
(Table 1)
There was a significant increase in bony tibial
slope in both compartments following
MOWHTO. When a change in bony tibial slope
was detected in an individual patient, the change
was larger in the medial compartment, with the
average change also significantly greater
(p<0.01) in the medial compartment (2.4°±1.3°)
compared with the lateral compartment
(0.9°±1.1°). There was also a significant
increase (p<0.01) in the lateral tibial meniscal
slope of 0.9°±1.4°, which was equivalent to the
change in the bony lateral slope. The amount of
frontal correction was not significantly
associated with the amount of change in slope.
Conclusions
The results suggest that the modification of the
bony slope is larger in the medial compartment
after MOWHTO, which is likely related to the
location of the hinge on the lateral tibial cortex.
These findings suggest that consideration of
the medial and lateral tibial slope intra-
operatively could be important to identify the
optimal location of the hinge. However, further
studies are required before recommending any
modification to the surgical technique, as the
potential clinical consequences of tibial slope
alterations remain unknown.
Table 1 : Preoperative and post-operative measurements (°) of bony and meniscal slopes in the medial and
lateral compartments of the knee.
Preoperative
Post-operative
Changes
p Value
Medial Bony Slope
93.6 ± 4.3
96.0 ± 4.0
2.4 ± 1.3
p<0.01
Lateral Bony Slope
95.5 ± 3.4
96.4 ± 3.3
0.9 ± 1.1
p<0.01
Medial Meniscal Slope
NA
NA
NA
P<0.01
Lateral Meniscal Slope
91.2 ± 3.1
92.1 ± 3.3
0.9 ± 1.4
p = 0.01
Literature
[1] Lustig S, Scholes CJ, CostaAJ, Coolican MJ,
Parker DA. Different changes in slope between the medial
and lateral tibial plateau after open-wedge high tibial
osteotomy.
Knee Surg Sports Traumatol Arthrosc. 2013 Jan;
21(1): 32-8.
[2] Lustig S, Scholes CJ, Leo SP, Coolican M,
Parker DA. Influence of soft tissues on the proximal bony
tibial slope measured with two-dimensional MRI.
Knee Surg
Sports Traumatol Arthrosc. 2013 Feb; 21(2): 372-9.
[3] Lustig S, Scholes CJ, Balestro JC, Parker
DA.
In vivo
assessment of weight-bearing knee flexion
reveals compartment-specific alterations in meniscal slope.
Arthroscopy 2013 Oct; 29(10): 1653-60.