2015 ISAKOS Biennial Congress ePoster #1720

Change of Medial Laxity in Medial Opening Wedge High Tibial Osteotomy

Seung-Suk Seo, MD, PhD, Busan KOREA, REPUBLIC OF
Do-Hun Kim, MD, MMSc, Busan KOREA, REPUBLIC OF
Bumin Hospital, Busan, KOREA

FDA Status Not Applicable

Summary: Medial laxity was increased after sMCL release during open wedge high tibial osteotomy. However, medial laxity was improved with internal fixation of osteotomy site to the level of before sMCL release under anesthesia. The improvement in medial laxity was maintained till postoperative 6 months. In conclusion, sMCL release during OWHTO is a safe method regarding to medial stability

Abstract:

Purpose

To evaluate the effect of superficial medial collateral ligament release(sMCL) on the medial knee stability during and following medial open-wedge high tibial osteotomy.

Materials And Methods

From May 2012 September 2013, 73 cases were undertook open-wedge high tibial osteotomy due to osteoarthritis. Among them, 47 cases who were followed minimum postoperative 6 months were included in this study. Pre-operative valgus stress radiography in knee 20° flexion were taken. Intraoperative valgus stress x-ray in knee 0° and 20° flexion position were taken in serial using image intensifier, such as, before and after medial collateral ligament release, after internal fixation. Postoperative valgus stress radiography in knee 20° flexion were taken at postoperative 3 months and 6 months. Osteotomy sites were fixed with TomoFix™ and were grafted with allogenic bone chips. 15kilo-pound force was used for valgus stress. All captured images were analyzed in the PACS system.

Results

Differences in medial laxity were seen at pre-operative and before release of sMCL under anesthesia, before and after release of sMCL under anesthesia, and after release of sMCL and after internal fixation under anesthesia (respectively, p<0.0001, p<0.0001, p<0.0001). There were differences in medial laxity between internal fixation under anesthesia and at postoperative 3months (p=0.0014) but was no difference in between postoperative 3 months and 6 months (p=0.5165). There was no difference between before release of sMCL and after internal fixation under anesthesia (p=0.7169).

Conclusion

Medial laxity was increased after sMCL release during open wedge high tibial osteotomy. However, medial laxity was improved with internal fixation of osteotomy site to the level of before sMCL release under anesthesia. The improvement in medial laxity was maintained till postoperative 6 months. In conclusion, sMCL release during open-wedge high tibial osteotomy is a safe method regarding to medial stability.