title: Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis.
abstract: OBJECTIVE
  In this study, postoperative changes in the posterior tibial slope angle and clinical outcomes following open-wedge high tibial osteotomy were evaluated.
  
  
  METHODS
  This study included 39 knees (18 left, 21 right) of 35 patients (three male, 32 female; median age, 53 years; age range 37-64 years) with symptomatic isolated medial joint osteoarthritis who underwent open-wedge high tibial osteotomy and fixation with a Puddu plate. The patients were clinically assessed according to the Lysholm knee score, a visual analogue pain scale, and a patient satisfaction questionnaire. Radiological assessment was made according to the changes in the posterior tibial slope angle and the correlation between these changes and clinical signs. The median follow-up period was 11 years (range 7-14 years).
  
  
  RESULTS
  Significant improvements were observed in the preoperative and postoperative clinical scores of the Lysholm knee scale, visual analogue pain scale, and patient satisfaction questionnaire (p < 0.05). Radiological assessment showed that the posterior tibial slope angle was significantly higher during the postoperative and follow-up periods (p  0.05). There was no correlation between the postoperative Lysholm scores and the increase in the posterior tibial slope angle (p = n.s.).
  
  
  CONCLUSIONS
  We conclude that both the conventional Puddu plate design and its anteromedial plate placement are what increase the tibial slope after an opening-wedge proximal tibial osteotomy. Therefore, current new plate design may help preserve the posterior tibial slope angle.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedics, Istanbul Baskent University Hospital, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Ozel
authors.affiliation: Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Atakent Mahallesi, Turgut Ozal Caddesi, No: 1, Kucukcekmece, 34303, Istanbul, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Yucel
authors.affiliation: Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Atakent Mahallesi, Turgut Ozal Caddesi, No: 1, Kucukcekmece, 34303, Istanbul, Turkey. serhatmutlu@hotmail.com.
authors.forename: Serhat
authors.initials: S
authors.lastname: Mutlu
authors.affiliation: Department of Orthopaedics, Silivri Government Hospital, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Orman
authors.affiliation: Department of Orthopaedics, Taksim Training and Research Hospital, Istanbul, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Mutlu
mesh_terms: D000328:Adult; D001860:Bone Plates; D005260:Female; D056305:Genu Varum / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Lysholm knee score; Medial joint osteoarthritis; Open-wedge high tibial osteotomy; Posterior tibial slope angle