Open AccessMedial Open Wedge High tibial Osteotomy (MOWHTO) does not relevantly alter patellar kinematics: a cadaveric study
Author(s) -
Felix Greimel,
Günther Maderbacher,
Christel Baier,
Bernd Krieg,
Florian Zeman,
Joachim Grifka,
Armin Keshmiri
Publication year - 2020
Publication title -
archives of orthopaedic and trauma surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.33
H-Index - 78
eISSN - 1434-3916
pISSN - 0936-8051
DOI - 10.1007/s00402-020-03578-1
Subject(s) - high tibial osteotomy , cadaveric spasm , medicine , kinematics , osteotomy , orthopedic surgery , patella , orthodontics , anterior knee pain , anatomy , surgery , osteoarthritis , physics , alternative medicine , pathology , classical mechanics
Purpose The purpose of this study was to quantify the influence of medial open wedge high tibial osteotomy on patellar kinematics using optical computer navigation, as anterior knee pain infrequently occurs postoperatively and the reason is still being unknown. Methods Ten medial open wedge high tibial osteotomies at supratuberosity level in 5 full body specimens were performed. The effect of the surgical procedure on patellar kinematics, measured at 5 and 10 degrees of leg alignment correction angle, was analyzed and compared to native patellar kinematics during passive motion—regarding patella shift, tilt, epicondylar distance and rotation. Linear mixed models were used for statistical analysis, a two‐sided p value of ≤ 0.05 was considered statistically significant. Results Tilt behavior, medial shift and epicondylar distance did not show a significant difference regarding natural patellar kinematics at both osteotomy levels. Both osteotomy correction angles showed a significant less external rotation of the patella ( p < 0.001, respectively) compared to natural kinematics. Conclusions Except less external rotation of the patella, medial open wedge high tibial osteotomy does not seem to relevantly alter patellar alignment during passive motion. Future clinical studies have to prove the effect of MOWHTO on patellar kinematics measured in this experimental setup, especially regarding its influence on anterior knee pain.