![]() Methods Medical records of all patients subm. This may be beneficial for patients with small cartilage defects on the medial patellar facet, but caution is advised in the indication of ascending biplanar OWHTO in patients with already increased preoperative TT-TG distance. Objectives To assess the impact of a biplanar ascending opening-wedge high tibial osteotomy (OWHTO) on the alignment of the knee extensor mechanism and patellar height using preoperative and postoperative MRI. This is the first study that comprehensively shows the significant lateralization of the extensor mechanism after an ascending biplanar OWHTO utilizing MRI. The amoubetween nt of the osteotomy opening positively correlated with the postoperative MISI (p = 0.033), BPI (p = 0.023) and CDI (p = 0.013). Patellar height significantly decreased when evaluated by the BPI (p < 0.001) and CD (p = 0.001). Postoperatively, TT-TG distance significantly increased by 2.06 mm (p < 0.001), and TT-PCL distance increased by 0.95 mm without reaching significance (p = 0.063). Interobserver reliability for all measurements ranged between 73.3% and 89.3%. ResultsĪ total of 26 patients that underwent ascending biplanar OWHTO were enrolled in this imaging analysis. In the illustration above, we have a consolidation period where the bears are clearly in. The illustration below shows the characteristics of a falling wedge. This also means that the pattern is likely to break to the upside. Bivariate regression analysis was used to investigate the association of the amount of HTO opening and the assessed PF joint parameters. The falling wedge is the inverse of the rising wedge where the bears are in control, making lower highs and lower lows. Paired T-test was performed to compare pre- and- the postoperative measurements. ![]() Interobserver reliability was assessed with the intraclass correlation coefficient (ICC). A right-angled ascending broadening wedge is a downward reversal pattern. Four parameters of the extensor mechanism - tibial tubercle-trochlea groove distance (TT-TG), tibial tubercle-posterior cruciate ligament distance (TT-PCL), patellofemoral axial engagement index (AEI), and lateral patellar tilt (LPT) – and four patellar height indices - Insall-Salvati index (ISI), modified Insall-Salvati index (MISI), Blackburne-Peel index (BPI), and Caton-Deschamps index (CDI) – were measured by two blinded independent observers on both pre- and postoperative MRIs. ![]() Medical records of all patients submitted to ascending biplanar OWHTO between July 2008 and March 2017 were retrospectively assessed. The purpose of the study is to assess the impact of a biplanar ascending OWHTO on the alignment of the knee extensor mechanism and patellar height utilizing pre- and postoperative MRI. No previous study comprehensively evaluated the influence of an ascending biplanar OWHTO on the PF joint alignment using magnetic resonance imaging (MRI). The influence of ascending biplanar opening-wedge hight tibial osteotomy (OWHTO) on patellofemoral alignment is still uncertain. ![]()
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