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Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to clarify the causes of the increase in the posterior tibial slope during open-wedge high tibial osteotomy (HTO) and to investigate whether its changes influenced the correction angle in frontal plane.

Methods

We retrospectively reviewed 20 patients (26 knees) treated with open-wedge HTO. They were divided into the following two groups. Group A consisted of the knees whose opening gaps were fixed using a spacer plate having the trapezoidal block with a 2° posterior slope. In Group B, anterior and posterior opening gaps were fixed separately. The posterior tibial slope and the hip–knee–ankle angle were measured based on CT data. The relationship between the correction rate in frontal plane and the changes of posterior tibial slope was investigated.

Results

Increase in the posterior tibial slope was 2.1 ± 2.5° in Group A and 0.2 ± 1.2° in Group B, which showed a statistical difference (P = 0.02). The difference between the hip–knee–ankle angles before and after operation was 5.2 ± 2.3° in Group A and 5.5 ± 2.5° in Group B. The correction rate was statistically correlated with the changes of posterior tibial slope (R = −0.55, P = 0.003).

Conclusion

To avoid increase in the posterior tibial slope, the trapezoidal block with a only 2° posterior slope in a spacer plate was not sufficient, and it was necessary to fix anterior and posterior gaps separately. The correction angle in frontal plane had a trade-off relationship with the changes in posterior tibial slope. Thus, we thought that increase in the posterior tibial slope might result in correction loss.

Level of evidence

Therapeutic study, Retrospective comparative study, Level III.

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Ethical board review statement

All patients agreed to participate in the study. The patient consent procedure strictly involved disclosure, understanding, and voluntariness. The study protocol was noted to accord with a criterion of the Institutional Review Board in the Kinki University Hospital that the approval of the committee is not needed.

Conflict of interest

All authors do not have any financial support and any competing interest with regard to this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama City, Osaka, 589-8511, Japan

    Shigeki Asada, Masao Akagi, Shigeshi Mori, Tetsunao Matsushita, Kazuki Hashimoto & Chiaki Hamanishi

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  1. Shigeki Asada
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  2. Masao Akagi
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  3. Shigeshi Mori
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  4. Tetsunao Matsushita
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  5. Kazuki Hashimoto
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  6. Chiaki Hamanishi
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Correspondence to Shigeki Asada.

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Asada, S., Akagi, M., Mori, S. et al. Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 20, 571–578 (2012). https://doi.org/10.1007/s00167-011-1610-1

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  • DOI: https://doi.org/10.1007/s00167-011-1610-1

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