PLATEAU-PATELLA ANGLE: AN OPTION FOR ASSESSING PATELLAR HEIGHT ON PROXIMAL TIBIA OSTEOTOMY

Area of Science:

• Orthopedic Surgery
• Radiology
• Biomechanical Analysis

Background:

• Accurate patellar height measurement is critical for evaluating outcomes after high tibial osteotomy (HTO).
• Established methods like Insall-Salvati, Caton-Deschamps, and Blackburne-Peel are commonly used.
• The plateau-patella angle is a newer method for assessing patellar position.

Purpose of the Study:

• To compare the efficacy of the plateau-patella angle method with established techniques for measuring patellar height.
• To evaluate changes in patellar height and tibial slope following medial opening high tibial osteotomy.

Main Methods:

• Retrospective analysis of 13 patients who underwent medial opening high tibial osteotomy.
• Pre- and post-operative radiographs were used to measure patellar height using Insall-Salvati, Caton-Deschamps, Blackburne-Peel, and plateau-patella angle methods.
• Tibial slope and patellar tendon length were also measured; interobserver reliability was assessed.

Main Results:

• The plateau-patella angle showed a mean decrease from 23.15° preoperatively to 20.46° postoperatively.
• Traditional methods (Insall-Salvati, Caton-Deschamps, Blackburne-Peel) also showed changes, but the plateau-patella angle's changes correlated with tibial slope alterations.
• Good interobserver reliability was found for all methods, with plateau-patella angle at 0.67 (p <0.001).

Conclusions:

• The plateau-patella angle method is influenced by changes in tibial slope after high tibial osteotomy.
• This correlation suggests the plateau-patella angle may overestimate the reduction in patellar height post-surgery.
• Clinical implications include potential overestimation of patellar height reduction when using the plateau-patella angle method compared to classical techniques.