title: Radiological analysis of closed-wedge high tibial osteotomy.
abstract: OBJECTIVE
  In this study, we aimed to evaluate changes in frontal plane (anatomical axis) and sagittal plane (tibial slope, patellar height) parameters following closed-wedge high tibial osteotomy (HTO) and possible correlations between them.
  
  
  METHODS
  Between June 2003 and May 2007, 15 knees of the 13 female patients (mean age 52.6 years; range 45 to 64 years) who were followed on a regular basis in our outpatient clinic and underwent closed-wedge HTO were included. The mean follow-up was 49 months (range 29-75 months). Radiologic analysis was performed using pre- and postoperative anatomical axis, tibial slope, and patellar height measurements [Caton index (CI) and Insall-Salvati index (ISI)]. The findings were analyzed by using Wilcoxon matched pairs test and Pearson's correlation test.
  
  
  RESULTS
  Preoperative varus deformity was 6.3° ± 2.7°, while it was measured as 7.2° ± 2.5° valgus in the last visit (p=0.0004). The pre- and postoperative CI were 0.97 ± 0.1 and 0.96 ± 0.1, respectively (p=0.85). The ISI decreased from 1.23 ± 0.15 to 1.14 ± 0.15 (p=0.012). Patella baja was observed in only one patient (ISI=0.77). Preoperatively tibial slope was 6.5° ± 2.4°, while it was measured as 0.06° ± 3.4° in the last visit (p=0.0001). There was no correlation between frontal plane angle change and tibial slope, also between patellar height and tibial slope.
  
  
  CONCLUSIONS
  Closed-wedge HTO does not result in significant changes in patellar height. The risk of patella baja can be decreased through minimal dissection around patellar tendon. However, closed-wedge HTO reduces tibial slope significantly. Optimal resection from posterior tibia is necessary to prevent this condition. A possible loss of tibial slope should be considered in the further reconstructive procedures.
authors: Department of Orthopedics and Traumatology, Bursa Şevket Yılmaz Training and Research Hospital, Turkey.
authors: Ali
authors: A
authors: Turgut
authors: Cemil
authors: C
authors: Kayali
authors: Haluk
authors: H
authors: Ağuş
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D010329:Patella / Q000000981:diagnostic imaging*; D011859:Radiography; D020127:Recovery of Function; D013977:Tibia / Q000000981:diagnostic imaging*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome