Bode, Lisa and Kuehle, Jan and Brenner, Anna-Sophie and Freigang, Viola and Eberbach, Helge and Niemeyer, Philipp and Suedkamp, Norbert P. and Schmal, Hagen and Bode, Gerrit (2022) Patellofemoral cartilage defects are acceptable in patients undergoing high tibial osteotomy for medial osteoarthritis of the knee. BMC MUSCULOSKELETAL DISORDERS, 23 (1): 489. ISSN , 1471-2474
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Background: Patients suffering cartilage defects of the medial compartment with underlying varus deformity do benefit from high tibial osteotomy (HTO) even in the long term. Nonetheless, kinematic and geometric changes especially in the patellofemoral joint have been described. Purpose of the present study was to evaluate the influence of patellofemoral cartilage defects detected during the diagnostic arthroscopy and their influence on HTO's postoperative outcome. Methods: Ninety patients with a mean follow-up of 10.08 +/- 2.33 years after surgery were included. Patients were divided into four groups according to their cartilage status in the patellofemoral joint (A= no defects, B = isolated lesions of the patella, C = isolated lesions of the trochlea, D = kissing lesions). Functional outcome was evaluated before surgery and about ten years thereafter by relying on the IKDC, Lysholm, and KOOS scores. Radiological parameters were assessed pre- and six weeks postoperatively. Results: In groups A to D, the HTO led to significant patellar distalisation in the sagittal view, with the mean indices remaining at or above the limit to a patella baja. All patients in all groups profited significantly from HTO (higher Lysholm score, lower VAS p< 0.001), patients in group D had the lowest outcome scores. Patella height negatively influenced outcome scores in group C (Blackburne-Peel-Index-VAS p= 0.033) and D (Caton-Deschamps-Index-Tegner p= 0.018), a larger valgus correction was associated with lower outcome scores in group D (Lysholm p= 0.044, KOOSpain 0.028, KOOSQOL p= 0.004). Conclusion: Long-term results of HTO for varus medial compartment osteoarthritis remain good to excellent even in the presence of patellofemoral defects. Overcorrection should be avoided. Distal biplanar HTO should be considered for patients presenting trochlear or kissing lesions of the patellofemoral joint.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | OPENING-WEDGE; PATELLAR HEIGHT; PROGRESSION; ALIGNMENT; SUPERIOR; Knee; High tibial osteotomy; Varus deformity; Patella; Cartilage defects |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Feb 2024 09:51 |
| Last Modified: | 27 Feb 2024 09:51 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58098 |
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