ISAKOS: 2019 Congress in Cancun, Mexico

2019 ISAKOS Biennial Congress ePoster #1223


Effect of Posterior Tibial Slope Increase in Opening Wedge High Tibial Osteotomy on Functional Outcomes

Seung-Min Na, MD, Gwangju KOREA, REPUBLIC OF
Eun-Kyoo Song, MD, PhD, Prof., Gwangju KOREA, REPUBLIC OF
Jong-Keun Seon, MD, PhD, Hwasun, Jeonnam KOREA, REPUBLIC OF

Chonnam National University Hospital, Gwangju, KOREA, REPUBLIC OF

FDA Status Cleared


A surgeon should keep in mind that increased posterior tibial slope may have adverse effect on clinical outcomes in patients after medial opening-wedge HTO.



Little information is available regarding the effect of posterior tibial slope change after valgus opening-wedge high tibial osteotomy (HTO) on functional outcomes. This prospective study was undertaken to evaluate changes in posterior tibial slope after valgus opening-wedge HTO and the effect of increased posterior tibial slope on functional outcomes after a minimum follow-up of 3 years.


One hundred and forty patients that underwent HTO for medial unicompartmental OA with a minimum follow-up of 3 years were included in this study. Changes in posterior tibial slope after surgery were evaluated on lateral knees radiographs. Mean increase of posterior tibial slope was 1.74° ± 2.42° at final follow up. Knees were divided into two groups (=5° (n;117), group A and >5° (n;23), group B) based on posterior tibial slope increases after surgery. Range of motion, flexion contracture, HSS and WOMAC scores, and subjective satisfaction were compared in the two groups.


All functional scores were significantly improved in both groups at final follow-up. Mean HSS and WOMAC scores at final follow-up were better in group A (88.6 vs. 83.9 and 29.5 vs. 35.8; P<0.05). However, no significant inter-group differences were observed for range of motion, flexion contracture, patient subjective satisfaction, or mechanical femorotibial angle.


Valgus opening-wedge HTO improves clinical results in patients with medial unicompartmental osteoarthritis. However, it was found that an increased posterior tibial slope detrimentally affect clinical outcomes in patients after HTO.