Document Type: RESEARCH PAPER

Authors

1 Bone Joint and Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Undergraduate program in Mathematics university of California Irvine, California, USA

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 (130±1.70versus 0.60±10). No significant changes were seen in JDA (P=0.45) and LDTA (P=0.071). LDT-GSA changed significantly (P=0.011) from 8.10±10 in varus to -0.30±0.50 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

Main Subjects

1. Kazemi SM, Minaei R, Safdari F, Keipourfard A, Forghani
R, Mirzapourshafiei A. Supracondylar osteotomy
in valgus knee: angle blade plate versus locking
compression plate. Arch Bone Jt Surg. 2016; 4(1):29-34.
2. Issın A, Sahin V, Koçkara N, Gürsu SS, Kurtuldu A,
Yıldırım T. Is proximal tibia the major problem in
varus gonarthrosis? Evaluation of femur and ankle.
Eklem Hastalik Cerrahisi. 2012; 23(3):128-33.
3. Madadi F, Eajazi A, Madadi F, Daftari Besheli L, Rokni
R, Abbasian MR, et al. Clinical results of reversed 

V-shaped high tibial corticotomy with minimally
invasive surgery without internal fixation devices.
Orthopedics. 2010; 33(6):388-92.

4. Baumgarten KM, Meyers KN, Fealy S, Wright TM,
Wickiewicz TL. The coronal plane high tibial osteotomy.
Part II: a comparison of axial rotation with the opening
wedge high tibial osteotomy. HSS J. 2007; 3(2):155-8.
5. Kendoff D, Lo D, Goleski P, Warkentine B, O’Loughlin
PF, Pearle AD. Open wedge tibial osteotomies influence
on axial rotation and tibial slope. Knee Surg Sports
Traumatol Arthrosc. 2008; 16(10):904-10.
6. Puddu G, Cipolla M, Cerullo G, Franco V, Giannì􀆰 E.
Which osteotomy for a valgus knee? Int Orthop. 2010;
34(2):239-47.
7. Dowd GS, Somayaji HS, Uthukuri M. High tibial
osteotomy for medial compartment osteoarthritis.
Knee. 2006; 13(2):87-92.
8. Saragaglia D, Mercier N, Colle PE. Computer-assisted
osteotomies for genu varum deformity: which osteotomy
for which varus? Int Orthop. 2010; 34(2):185-90.
9. Nelissen EM, van Langelaan EJ, Nelissen RG. Stability
of medial opening wedge high tibial osteotomy: a
failure analysis. Int Orthop. 2010; 34(2):217-23.
10. Tunggal JA, Higgins GA, Waddell JP. Complications of
closing wedge high tibial osteotomy. Int Orthop. 2010;
34(2):255-61.
11. Watanabe K, Tsuchiya H, Matsubara H, Kitano S,
Tomita K. Revision high tibial osteotomy with the
Taylor spatial frame for failed opening-wedge high
tibial osteotomy. J Orthop Sci. 2008; 13(2):145-9.
12. Weidenhielm L, Svensson OK, Broström LÅ􀇒 . Change of
adduction moment about the hip, knee and ankle joints
after high tibial osteotomy in osteoarthrosis of the
knee. Clin Biomech (Bristol, Avon). 1992; 7(3):177-80.
13. Tarr RR, Resnick CT, Wagner KS, Sarmiento A.
Changes in tibiotalar joint contact areas following
experimentally induced tibial angular deformities.
Clin Orthop Relat Res. 1985; 3(199):72-80.
14. Takeuchi R, Saito T, Koshino T. Clinical results of a
valgus high tibial osteotomy for the treatment of
osteoarthritis of the knee and the ipsilateral ankle.
Knee. 2008; 15(3):196-200.
15. Tallroth K, Harilainen A, Kerttula L, Sayed R. Ankle
osteoarthritis is associated with knee osteoarthritis.
Conclusions based on mechanical axis radiographs.
Arch Orthop Trauma Surg. 2008; 128(6):555-60.