Medial opening wedge tibial osteotomy and the sagittal plane: the effect of increasing tibial slope on tibiofemoral contact pressure

The American Journal of Sports Medicine
Craig M RodnerRobert A Arciero

Abstract

Altering the tibial slope in an anterior cruciate ligament-deficient knee has been shown to affect anterior-posterior tibial translation. The effects on articular contact pressure of altering tibial slope during a high tibial osteotomy are unknown. Performing an opening wedge osteotomy anterior to the midaxial line will increase tibial slope. Increasing tibial slope with a high tibial osteotomy in an anterior cruciate ligament-deficient knee redistributes tibiofemoral joint contact pressures onto the posterior tibial plateau. Controlled laboratory study. Medial opening wedge high tibial osteotomies were performed, and a plate fixation with a known diameter inset was placed along the medial tibia in an anterior position and a posterior position on 9 cadaveric knees. Medial and lateral tibiofemoral contact pressures were measured at the resulting 2 different tibial slopes in both ligament-intact and ligament-deficient states using thin electronic sensors. Anterior plate application resulted in an increase in posterior tibial slope by an average of 6.6 degrees (P < .001) compared with posterior plate placement. After medial opening wedge high tibial osteotomy, the mean peak lateral tibiofemoral contact pressure (3.4 MPa) was signi...Continue Reading

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