Preoperative flexion contracture is a predisposing factor for cartilage degeneration at the patellofemoral joint after open wedge high tibial osteotomy

Otsuki Shuhei; Ikeda Kuniaki; Wakama Hitoshi; Okuno Nobuhiro; Okamoto Yoshinori; Okayoshi Tomohiro; Miyamoto Yuki; Neo Masashi

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자료유형: 학술저널

저자정보: Otsuki Shuhei (Department of Orthopedic Surgery Osaka Medical College) Ikeda Kuniaki (Department of Orthopedic Surgery Osaka Medical College) Wakama Hitoshi (Department of Orthopedic Surgery Osaka Medical College) Okuno Nobuhiro (Department of Orthopedic Surgery Osaka Medical College) Okamoto Yoshinori (Department of Orthopedic Surgery Osaka Medical College) Okayoshi Tomohiro (Department of Orthopedic Surgery Osaka Medical College) Miyamoto Yuki (Department of Orthopedic Surgery Osaka Medical College) Neo Masashi (Department of Orthopedic Surgery Osaka Medical College)

저널정보: 대한슬관절학회 Knee Surgery and Related Research Knee Surgery and Related Research 제32권

발행연도: 2020.1

수록면: 55 - 55 (1page)

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The purpose of the study was to determine the effect of cartilage degeneration at the patellofemoral joint on clinical outcomes after open wedge high tibial osteotomy and to investigate the predisposing factors for progressive patellofemoral cartilage degeneration.Seventy-two knees were evaluated on second-look arthroscopy in patients who opted for plate and screw removal at an average of 20.1?months after osteotomy. Cartilage degeneration at the patellofemoral joint was evaluated using the International Cartilage Repair Society grading system, with cases divided into progression and nonprogression groups. Radiographic parameters of the patellofemoral anatomy, knee range of motion, and clinical outcomes were evaluated from the preoperative baseline to the final follow up, on average 50?months after osteotomy. A contracture >?5° was considered a flexion contracture. Cartilage degeneration progressed in 31 knees, and preoperative knee flexion contracture was significantly associated with progressive degeneration ( P <?0.01). The Lysholm and Kujala scores were significantly lower in the progression group (87.9 and 85.3, respectively) than in the nonprogression group (91.6 and 93.6, respectively) ( P <?0.05). The odds ratio of the flexion contracture resulting in progression of patellofemoral cartilage degeneration was 4.63 (95% confidence interval, 1.77?12.1). No association was detected between progressive degeneration and age, sex, body mass index, Kellgren-Lawrence grade, or radiographic parameters. Flexion contracture may be associated with progression of cartilage degeneration at the patellofemoral joint and may negatively affect the clinical outcomes after open wedge, high tibial osteotomy.

#Knee #Open wedge high tibial osteotomy #Range of motion #Cartilage degeneration #Patellofemoral joint #Clinical outcome

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