A Retrospective Study Of The Effect Of Open Wedge High Tibial Osteotomy On Patellarposition

ObjectiveTo explore the change of the patella position caused by medial open wedge high tibial osteotomy(MOWHTO)in the treatment of knee osteoarthritis(KOA)in the medial compartment of genu varus,and to evaluate the clinical effect of the surgery.MethodThrough the method of retrospective study,we collected the imaging data and knee function scores of patients with knee osteoarthritis in the single compartment of genu varus who underwent MOWHTO surgery in the Department of arthrology of Guangdong Hospital of traditional Chinese medicine from 2017 to 2019,evaluated the changes of patella position and knee function after surgery,and explored the influence of OWHTO on patella position after surgery and evaluate the clinical effect.ResultThe position of patella was affected by high medial open wedge tibial osteotomy.The postoperative Caton-Deschamps index,the blackburne-peel index and the patellar tilt angle were compared with those before surgery decreased and the difference was statistically significant(P<0.05).The posterior tibial slop after operation increased and the difference was statistically significant(P<0.05).The Insall-Salvati index and congruence angle of patella after surgery had no significant change compared with that before surgery and the difference was not statistically significant(P>0.05).There was no significant change in imaging indexes at 6 months after surgery compared with that after surgery(P>0.05).In terms of clinical efficacy,the KSS score increased and the VAS score decreased 6 months after surgery compared with that before surgery(P<0.05).Hemoglobin and other indicators of anemia decreased,leukocyte and other inflammatory indicators increased,albumin decreased,coagulation and fibrinolysis indicators increased,and the change trend of each indicator tended to be stable about 5 days after surgery.ConclusionMedial open wedge high tibial osteotomy has a clear therapeutic effect in the treatment of knee osteoarthritis,which can significantly reduce pain and improve function.MOWHTO may result in the decrease of patella position,the decrease of patella tilt angle,and the increase of posterior tibal slop.Different evaluation indexes of patella height can lead to different results.