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Upper tibia osteotomy: long term results - realignment analysis using OASIS computer software.

George C Babis1, Kai-Nan An, Edmund Y S Chao

  • 1Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
|August 13, 2008
PubMed
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Establishing normal values for knee alignment after valgus upper tibial osteotomy is crucial. Optimal postoperative femorotibial angle (174-180 degrees), joint line obliquity (<4 degrees), and force distribution (40-60%) improve osteotomy survival rates.

Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Radiographic Analysis

Background:

  • Normal values for axial alignment and joint line obliquity following valgus upper tibial osteotomy are not well-established.
  • Successful outcomes in knee osteotomy require defined radiographic parameters.

Purpose of the Study:

  • To establish normal values for axial alignment and joint line obliquity after valgus upper tibial osteotomy.
  • To identify radiographic parameters predictive of successful osteotomy survival.

Main Methods:

  • Prospective study of 51 patients undergoing 54 lateral closing wedge upper tibial osteotomies.
  • Preoperative and postoperative hip-to-ankle radiographs analyzed using specialized software (OASIS).

Main Results:

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  • Osteotomy survival rates were 89% at 5 years and 76% at 10 years.
  • Femorotibial angle outside 174-180 degrees correlated with higher failure rates.
  • Optimal outcomes (100% survival) achieved with femorotibial angle 174-180 degrees, lateral joint line obliquity <4 degrees, and medial plateau force 40-60%.

Conclusions:

  • Preoperative planning incorporating specific alignment and force distribution criteria can enhance upper tibial osteotomy survival.
  • Precise surgical technique and rigid fixation are essential for optimal results.