Comparison of torsional changes in the tibia following a lateral closed or medial open wedge high tibial osteotomy

Umito Kuwashima, Ryohei Takeuchi, Hiroyuki Ishikawa, Mikio Shioda, Yasuharu Nakashima, Steffen Schröter

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Abstract

Objective: The aim of this study is to evaluate, by computed tomography (CT), whether different torsional changes occur in the tibia following a lateral closed wedge high tibial osteotomy (CWHTO) versus a medial open wedge high tibial osteotomy (OWHTO) procedure. It was hypothesized that the distal fragment of the tibia would show greater internal rotation after CWHTO. Methods: Thirty knees from 25 patients who underwent HTO were enrolled. Fifteen knees of 14 patients who underwent CWHTO and 15 knees of 11 patients who received OWHTO were match-paired. CT scans were taken before and three weeks after surgery. Rotational changes in the distal fragment of the tibia were assessed by measuring the tibial torsion angle (TTA). Results: The mean TTA in the CWHTO group pre-operatively and postoperatively was + 23.9° ± 7.8° and + 18.2° ± 7.0°, respectively. Internal rotation of the distal fragment of the tibia after CWHTO was − 5.7 ± 3.3° (P < 0.001). In the OWHTO group, the mean TTA pre-operatively and postoperatively was + 27.9° ± 6.9° and + 26.8 ± 7.7°, respectively, with no significant change in torsion observed (P > 0.05). Conclusions: The distal fragment of the tibia rotated internally after CWHTO but not after OWHTO. Level of evidence: Level III: case–control study.

Original languageEnglish
Pages (from-to)374-381
Number of pages8
JournalKnee
Volume26
Issue number2
DOIs
Publication statusPublished - Mar 2019

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All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

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