Proximal Tibiofibular Dislocation in a Closing-Wedge High Tibial Osteotomy Causes Lateral Radiological Gapping of the Knee : a Prospective Randomized Study
Torres-Claramunt, Raúl (Institut Hospital del Mar d'Investigacions Mèdiques)
Sánchez-Soler, Juan Francisco (Institut Hospital del Mar d'Investigacions Mèdiques)
Hinarejos Gómez, Pedro (Institut Hospital del Mar d'Investigacions Mèdiques)
Sala-Pujals, Aleix (Hospital del Mar (Barcelona, Catalunya))
Leal Blanquet, Joan (Hospital d'Igualada)
Monllau García, Joan Carles (Institut Hospital del Mar d'Investigacions Mèdiques)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Background: To determine whether a proximal tibiofibular joint dislocation (TFJD) increases lateral compartment gapping more than a fibular head osteotomy (FHO) during a closing-wedge high tibial osteotomy (CWHTO). The second objective was to determine whether lateral compartment gapping affects clinical outcomes. Methods: A prospective randomized clinical study was carried out that included 18 patients in Group 1 (FHO) and 18 in Group 2 (TFJD). Varus-stress radiographs of all the patients with both knees at full extension and at 30° of flexion were studied pre-operatively and 12 months post-operatively. Lateral compartment gapping was measured in millimeters. The Knee Society Score (KSS) was used to assess clinical stability. Results: The difference between the pre- and post-operative measurements relative to gapping in the lateral knee compartment at 0° of knee flexion was 1. 3 mm (SD 1. 8) in Group 1 and 4. 5 mm (SD 2. 4) in Group 2 (p = 0. 006). At 30° of knee flexion, this difference was 1. 9 mm (SD 1. 2) in Group 1 and 5. 2 mm (SD 3. 1) in Group 2 (p = 0. 01). No differences were observed in the pre- and post-operative period relative to gapping in healthy knees. Pre-operatively, both groups presented similar KSS knee values: Group 1 with 54. 7 (SD 11. 7), Group 2 with 54. 8 (SD 11. 1) (n. s. ). Post-operatively, these values were also similar: Group 1 with 93. 2 (SD 7. 4), Group 2 with 93. 5 (SD 5. 5) (n. s. ). Conclusions: In patients who have undergone a CWHTO, TFJ dislocation increases knee lateral compartment gapping when compared to an FHO at 0° and 30° of knee flexion. However, this fact seems to have no repercussion on the functional status of the knees as measured with the KSS at the one-year follow-up.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Closing-wedge osteotomy ; Knee stability ; Stress radiology ; Knee ; High tibial osteotomy
Published in:	Journal of clinical medicine, Vol. 9 Núm. 6 (2020) , p. 1622, ISSN 2077-0383

DOI: 10.3390/jcm9061622
PMID: 32471226

8 p, 1.1 MB

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