The effect of medial open wedge high tibial osteotomy on the patellofemoral joint: comparative analysis according to the preexisting cartilage status

BMC Musculoskeletal Disorders

卷:20

Hyun-Soo Moon¹  Chong-Hyuk Choi¹  Min Jung¹  Dae-Young Lee¹  Sung-Hwan Kim¹  Sang-Hoon Park²  Jong-Kwan Shin³ 

[1] Arthroscopy and Joint Research Institute, Yonsei University College of Medicine;

[2] Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital;

[3] Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine;

关键词: Knee;    High tibial osteotomy;    Patellofemoral joint;    Cartilage lesion;   

DOI  :  10.1186/s12891-019-2989-y

来源: DOAJ

【 摘 要 】

Abstract Background Although it has been known that medial open wedge high tibial osteotomy (MOWHTO) would adversely affect the patellofemoral joint, no previous study examined the surgical outcome of MOWHTO according to the preexisting cartilage status of the patellofemoral joint. The aim of this study was to investigate the effect of MOWHTO on the patellofemoral joint with regard to objective and subjective aspects according to the preexisting cartilage status. Methods Ninety-two patients who underwent MOWHTO and a following second-look arthroscopic assessment were included in this study. The patients were divided into two groups according to the preexisting cartilage status of the patellofemoral joint: group 1 (International Cartilage Repair Society [ICRS] grade 2 or 3) and group 2 (ICRS grade 0 or 1). Comparative analysis was performed regarding clinical scores, radiographic parameters, and arthroscopic measurements between the two groups. Results Clinical outcomes showed overall improvement from baseline to the time of second-look operation, with no significant difference between the two groups at each time point. There were no significant differences in radiographic parameters between the two groups. Radiographic grade of patellofemoral osteoarthritis in both groups showed a tendency to progress, without statistical significance. In arthroscopic assessment, the size of the cartilage lesion on the patellofemoral joint increased with time in both groups (P = 0.003), but the degree of change over time between the two groups was not statistically significant. Consistently, there was no significant difference in the frequency of progression of cartilage lesion grade in the patellofemoral joint between the two groups. Conclusions MOWHTO would contribute to osteoarthritis progression of the patellofemoral joint regardless of the preexisting cartilage status, without an association with clinical outcomes in short-term follow-up.

【 授权许可】

Unknown