A patellar tendon length conservation method: Biplanar retrotubercle open-wedge proximal tibial osteotomy

Abstract

OBJECTIVE: The early-period results of our technique for performing a medial biplanar retrotubercle open-wedge proximaltibial osteotomy for the surgical treatment of varus gonarthrosis were evaluated and compared with those reported in theliterature.METHODS: The clinical and radiological results of a medial biplanar retrotubercle open-wedge proximal tibial osteotomyperformed on 23 knees in 22 patients with medial gonarthrosis with varus alignment were analyzed.RESULTS: Twenty patients were female and 2 were male. At the time of surgery, the mean age was 56.22 years (44–66years), the mean body mass index was 31.95 kg/m2 (23.4–44.9 kg/m2), and the mean Hospital for Special Surgery (HSS)score was 68.7 (48–83). The mean preoperative femorotibial anatomical axis angle was 186.39° (173–194°), and the meanInsall-Salvati index value was 1.04 (0.94–1.171). The mean length of follow-up was 30.19 months (6–42 months). At thelast follow-up examination, the mean HSS score was 86.48 (74–100), the mean femorotibial anatomical axis angle was 175°(168–171°), and the mean Insall-Salvati index value was 1.06 (0.857–1.32). Comparison of the final follow-up values withthe preoperative values demonstrated significant improvement in the HSS score and femorotibial anatomical axis angle, butno significant difference in the Insall-Salvati index value.CONCLUSION: The results of this study indicated that frontal and sagittal plane deformities in patients with varus gonarthrosis can be treated with biplanar retrotubercle open-wedge proximal tibial osteotomy with good clinical results thatachieve patellar tendon length stability and avoid patellofemoral problems.