Abstract
Background: Medial opening wedge high tibial osteotomy (MOWHTO) may be indicated for patients who have varus alignment, medial knee pain, and medial knee compartment osteoarthritis. Another indication for MOWHTO is in patients with a history of recurrent anterior cruciate ligament (ACL) deficiency or failed ACL reconstruction (ACLR) with varus alignment. Some patients have MOWHTO combined with a primary or revision ACLR.
Methods: This is a retrospective case series that was approved by the Institutional Review Board at the authors’ institution. The purpose of this series is to report on average coronal plane alignment, posterior tibial slope (PTS), and patellar height (PH) for a consecutive cohort of 27 patients and discuss the significance of these findings. Another objective of this study is to report on how these measurements differ based on indication for MOWHTO— medial compartment osteoarthritis and varus deformity compared to patients with varus deformity and current or prior ACL pathology.
Results: This study found that for the entire cohort of patients, regardless of indication for surgery, the average PTS increased postoperatively, and PH stayed within normal limits. The magnitude of PTS increase was greater in the group of patients who had MOWHTO in the context of medial knee osteoarthritis and varus deformity (16 patients) when compared to the patients who had MOWHTO in combination with either ACLR or in the setting of ACL deficiency (11 patients). This may be due to the surgeon’s awareness of the tibial slope due to concomitant ACL deficiency or prior repair. There was no statistically significant difference between any of the variables postoperatively in the two groups.
Conclusion: It is important to evaluate how PTS and PH changes during MOWHTO may affect the future care for patients, such as when planning for future surgeries that a patient may have, like a total knee arthroplasty, primary ACLR, or revision ACLR. A surgeon being aware of possible changes to PTS and PH during surgery may yield less postoperative complications and keep the knee anatomy more biomechanically stable.
Recommended Citation
Nelson, Jessica A.; Brandon M. Painter; Dustin L. Richter; Jennifer S. Weaver; and Robert C. Schenck. "Change in Posterior Tibial Slope and Patellar Height During Medial Opening Wedge High Tibial Osteotomy: A Retrospective Cohort Study." Western Journal of Orthopaedics 13, 1 (2024). https://digitalrepository.unm.edu/wjo/vol13/iss1/9