The Effect of Open Wedge High Tibial Osteotomy on the Posterior Tibial Slope In Skeletally Mature Patient

High tibial osteotomy has been established as an efficient surgical intervention for young patients with uni-compartmental osteoarthritis of the knee. The principle of this surgery involves the realignment of the lower extremity to shift the load distribution from the medial compartment into the lateral compartment, thus leading to a decrease in symptoms related to medial compartment knee Osteoarthritis However, medial opening wedge high tibial osteotomy is also known to affect the posterior tibial slope angle , and it is reported that posterior tibial slope angle increases after medial opening wedge high tibial osteotomy .

Study Overview

• Status: Completed
• Conditions: Genu Varum
• Intervention / Treatment: Other: Observation

Detailed Description

High tibial osteotomy has been established as an efficient surgical intervention for young patients with uni-compartmental osteoarthritis of the knee. Medial opening wedge high tibial osteotomy is a well established surgery for patients with medial compartment knee osteoarthritis its most notable advantages include the precision of intraoperative angular correction, absence of the risk of peroneal nerve palsy in fibular osteotomy, absence of leg shortening, and preservation of bone stock.

The principle of this surgery involves the realignment of the lower extremity to shift the load distribution from the medial compartment into the lateral compartment, thus leading to a decrease in symptoms related to medial compartment knee Osteoarthritis However, medial opening wedge high tibial osteotomy is also known to affect the posterior tibial slope angle , and it is reported that posterior tibial slope angle increases after medial opening wedge high tibial osteotomy .

Satisfactory outcomes after surgery require optimal realignment both in the sagittal and coronal planes; in fact, poor realignment could lead to unsatisfactory clinical outcomes. An unintentional increase in posterior tibial slope angle after medial opening wedge high tibial osteotomy may influence knee kinematics and stability in the sagittal plane, which could lead to anterior translation of the tibial plateau, anterior shift of the tibiofemoral contact area, and subsequent redistribution of pressure into the posterior tibial plateau (particularly in knees with injured anterior cruciate ligaments). These conditions could result in articular cartilage degradation and further knee disability

• Study Type: Observational
• Enrollment (Actual): 40

Contacts and Locations

Study Locations

• Egypt
  • Assiut, Egypt
    • Mohamed Abdelfattah Abbas

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Data Collection:

The study and patients were collected according to number of patients, sex, age, Bodi Mass Index , Range of Motion ,type of plate & Screws used , Degree of deformity . Digital radiography, functional scores, software was used for statistical analysis. compare the Posterior Tibial Slope between the different Posterior Tibial Slope sides and sexes. One-way analysis of variance was used to compare the Posterior Tibial Slope between the different age groups. Posterior Tibial Slope was evaluated in all studies according to radiographic.

Description

Inclusion criteria

• Age: 20 : 65 years
• Genuvarus deformity
• 70° of range of motion
• Medial uni-compartmental osteoarthritis.

Exclusion criteria

• Posterior instability (relating to the posterior cruciate ligament)
• Body Mass Index under 30
• Sever Genuvarus > 20 degree

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Observations; number of patients, sex, age, Bodi Mass Index , Range of Motion ,type of plate & Screws used , Degree of deformity . Digital radiography (General Electric Healthcare ) functional scores software T-tests, One-way analysis of variance.	Other: Observation; Measure changes in tibial slope after medial opening wedge High tibial osteotomy in Skeletally mature patient with unicompartmental osteoarthitis and genuvarus knee; Evaluate the effect of tibial slope angle change on the clinical outcome at 1 year .

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Effect of Open Wedge High Tibial Osteotomy on the Posterior Tibial Slope In Skeletally Mature Patient	Measure changes in tibial slope after medial opening wedge High tibial osteotomy in Skeletally mature patient with unicompartmental osteoarthitis and genuvarus knee Evaluate the effect of tibial slope angle change on the clinical outcome at 1 year	Measure Posterior tibial slope by X Ray in Lateral View and Evaluate the effect of tibial slope angle change on the clinical outcome at 1 year

Collaborators and Investigators

• Sponsor: Al-Azhar University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2023
• Primary Completion (Actual): December 31, 2023
• Study Completion (Actual): January 1, 2024

Study Registration Dates

• First Submitted: February 15, 2024
• First Submitted That Met QC Criteria: February 28, 2024
• First Posted (Actual): March 1, 2024

Study Record Updates

• Last Update Posted (Actual): March 1, 2024
• Last Update Submitted That Met QC Criteria: February 28, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Bone Diseases; Genu Varum
• Other Study ID Numbers: OWHTOPTS

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No