No study has yet assessed the effect of medial open-wedge high tibial osteotomy (MOWHTO); on the patellofemoral joint according to postoperative alignment. According to recently published results, medial open-wedge high tibial osteotomy adversely affected; the patellofemoral joint. Overcorrection causing excessive valgus alignment led to further progression of degenerative changes in the patellofemoral joints; and inferior clinical outcomes, the authors wrote.
However, the postoperative weight-bearing ratio used as a predictive factor; for deterioration of the cartilage status in the patellofemoral joint after [medial open-wedge high tibial osteotomy]. Researchers retrospectively investigated 135 patients; who underwent medial open-wedge high tibial osteotomy. Patients grouped as having undercorrection; acceptable correction or overcorrection based on the postoperative weight-bearing line ratio.
Patellofemoral joint cartilage
During implant removal at 2 years after surgery; the postoperative change in cartilage status arthroscopically evaluated. At the mean follow-up of 52.1 months, clinical and radiological outcomes assessed. Factors that impacted deterioration of the patellofemoral joint cartilage status determined with regression analysis. However, a receiver-operating characteristic curve used to identify the cutoff point of where the postoperative weight-bearing ratio; correlated with the deterioration of cartilage status in the patellofemoral joint.
A total of 135 patients who underwent MOWHTO retrospectively investigated. The patients divided into 3 groups according to the postoperative weightbearing line ratio: undercorrection; acceptable correction, and overcorrection. However, the postoperative change in the cartilage status was assessed arthroscopically during implant removal at 2 years after MOWHTO.
However, the clinical and radiological outcomes were evaluated at a mean follow-up of 52.1 months. A regression analysis was performed to identify the factors affecting the deterioration of the patellofemoral joint cartilage status. A receiver operating characteristic curve employed to identify the cutoff point for the postoperative; WBLR associated with the deterioration of the cartilage status in the patellofemoral joint.
Incidence of cartilage progression
Results showed progression of cartilage degeneration in 39.3% of patients in the femoral trochlea; and in 23.7% of patients in the patella. The overcorrection group had a significantly higher incidence of cartilage progression compared with the undercorrection and acceptable correction groups. Patients in the overcorrection group had significantly worse function scores; which included the Lysholm knee score, KOOS and the Shelbourne and Trumper score.
However, the postoperative weight-bearing ratio had a significant impact on cartilage deterioration; according to results of a regression analysis. However, the cutoff point for correlation of the postoperative weight-bearing ratio with International Cartilage Repair Society grade progression was 62.1% and 62.2% for the femoral trochlea and patella, respectively.
But the patellofemoral joint adversely affected by MOWHTO. Overcorrection causing excessive valgus alignment led to further progression of degenerative changes; in the patellofemoral joints and inferior clinical outcomes. The postoperative WBLR can be used as a predictive factor for deterioration of the cartilage status in the patellofemoral joints after MOWHTO.