Alterations in Knee and Ankle Joint Orientation Following Medial Opening Wedge High Tibial Osteotomy: A Radiographic Analysis
Author : Dr. Ritesh K Singh, Dr. Sandeep V Gavhale, Dr. Vijay Chandele, Dr. Pranil Yadav, Dr. Vijay S Kumawat and Dr. Vaibhav Jagtap
Abstract :
Background: Medial opening wedge high tibial osteotomy (MOWHTO) is a reliable treatment for medial compartment osteoarthritis with varus deformity. While the primary aim is to correct coronal malalignment at the knee, realignment also alter ankle orientation. This study evaluated radiographic changes in knee and ankle joint orientation following MOWHTO.
Methods: Thirty patients (18 males, 12 females; mean age 48.6 years) underwent MOWHTO. Full-length standing hip–knee–ankle radiographs were obtained preoperatively and at six months postoperatively. Radiographic parameters included hip–knee–ankle (HKA) angle, mechanical medial proximal tibial angle (mMPTA), joint line convergence angle (JLCA), tibial plafond inclination (TPI), and talar tilt angle (TTA). Paired t-tests were used for analysis.
Results: The mean HKA angle improved from varus 7.8° ± 2.5° to valgus 2.1° ± 1.8° (p < 0.001). The mMPTA increased from 83.2° ± 2.1° to 90.5° ± 1.7° (p < 0.001), and the JLCA decreased from 4.2° ± 1.5° to 2.1° ± 1.2° (p < 0.05). At the ankle, TPI shifted from varus 2.8° ± 1.4° to valgus 0.9° ± 1.2° (p < 0.01), and TTA decreased from 1.6° ± 0.8° to 0.7° ± 0.6° (p < 0.05). No patient developed symptomatic ankle pain during follow-up.
Conclusion: MOWHTO effectively corrects knee varus deformity and induces significant changes in ankle orientation, as demonstrated by alterations in TPI and TTA.
Keywords :
High tibial osteotomy, knee alignment, ankle orientation, varus deformity, radiographic evaluation.
