ISAKOS: 2019 Congress in Cancun, Mexico

2019 ISAKOS Biennial Congress ePoster #1218


Three-Dimensional Comparison of Tibial Torsion Changes Following Lateral Closed Wedge or Medial Open Wedge High Tibial Osteotomy

Umito Kuwashima, MD, PhD, Tokyo JAPAN
Ryohei Takeuchi, MD, PhD, Yokosuka JAPAN
Masafumi Itoh, MD, Tokyo JAPAN
Junya Itou, MD, Tokyo JAPAN
Ken Okazaki, MD, PhD, Tokyo JAPAN

Department of Orthopaedic Surgery, Tokyo Women's Medical University, Sinjuku-ku, Tokyo, JAPAN

FDA Status Cleared


The distal fragment of tibia rotates internally after CWHTO to a significantly different extent than OWHTO.



We evaluated and compared torsional changes in the tibia after lateral closed wedge high tibial osteotomy (CWHTO) and medial open wedge high tibial osteotomy (OWHTO), and analyzed the effects on the patello-femoral joint using three dimensional measurements.


Thirty knees of 25 patients who underwent HTO were enrolled. Fifteen knees of 14 patients that underwent CWHTO and 15 knees of 11 patients that received OWHTO were match-paired.Computed tomography (CT) scans were taken before and at three weeks after surgery. Torsional changes in the tibia were assessed by measuring the tibial torsion angle (TTA) with three dimensional measurement. To evaluate the effects of tibial rotation on the patello-femoral joint, the tibial tuberosity-trochlear groove distance (TT-TG) was also measured.


Distal fragments of the tibia showed significant internal rotation after CWHTO but no significant change of rotation was observed in the OWHTO patients. The mean values for TT-TG in both HTO procedures cases decreased significantly after surgery. The TT-TG change after CWHTO decreased significantly compared with OWHTO (p < 0.001).


The distal fragment of tibia rotated internally and the TT-TG decreases after CWHTO. These findings were significantly different to the OWHTO patients.