Evaluation of Changes in the Tibiotalar joint after High Tibial Osteotomy

Abstract

Background: There are limited studies regarding the effects of high tibial osteotomy (HTO) on other areas of lower extremity. In current study, we investigated the changes of tibiotalar joint following HTO.

Methods: A total of 39 patients with genu varum requiring HTO were enrolled in this before and after study. The genu varus, joint diversion (JDA), lateral distal tibial (LDTA) and lateral distal tibial-ground surface (LDT-GSA) angles were measured before the operation and compared with 6 months after the surgery.

Results: Twenty threeout of39 patients (59%) were females. The genu varus angle decreased significantly (13°±1.7° versus 0.6°±1°). No significant changes were seen in JDA (P=0.45) and LDTA (P=0.071). LDT-GSA changed significantly (P=0.011) from 8.1°±1° in varus to -0.3°±0.5° in valgus.

Conclusion: Although HTO did not change the JDA and LDTA, however, significant change in LDT-GSAindicates that HTO can significantly decrease the shearing forces exerted on the ankle joint.

Keywords: Ankle joint; Genu varum; High tibial osteotomy; Joint diversion angle; Lateral distal tibial angle; Lower extremity; Tibiotalar joint.

Figures

Figure 1

Representative radiographic images used for measuring lower extremity angles: (A) Lateral distal tibial angle (LDTA); (B) Genu varum angle; (C) Joint diversion angle (JDA); (D) Lateral distal tibial-ground surface angle (LDT-GSA).

Figure 2

comparison of the angles before and after surgery.