A patellar tendon length conservation method: Biplanar retrotubercle open-wedge proximal tibial osteotomy

The early-period results of our technique for performing a medial biplanar retrotubercle open-wedge proximal tibial osteotomy for the surgical treatment of varus gonarthrosis were evaluated and compared with those reported in the literature.

The clinical and radiological results of a medial biplanar retrotubercle open-wedge proximal tibial osteotomy performed on 23 knees in 22 patients with medial gonarthrosis with varus alignment were analyzed.

Twenty patients were female and 2 were male. At the time of surgery, the mean age was 56.22 years (44-66 years), the mean body mass index was 31.95 kg/m² (23.4-44.9 kg/m²), and the mean Hospital for Special Surgery (HSS) score was 68.7 (48-83). The mean preoperative femorotibial anatomical axis angle was 186.39° (173-194°), and the mean Insall-Salvati index value was 1.04 (0.94-1.171). The mean length of follow-up was 30.19 months (6-42 months). At the last follow-up examination, the mean HSS score was 86.48 (74-100), the mean femorotibial anatomical axis angle was 175° (168-171°), and the mean Insall-Salvati index value was 1.06 (0.857-1.32). Comparison of the final follow-up values with the preoperative values demonstrated significant improvement in the HSS score and femorotibial anatomical axis angle, but no significant difference in the Insall-Salvati index value.

The results of this study indicated that frontal and sagittal plane deformities in patients with varus gonarthrosis can be treated with biplanar retrotubercle open-wedge proximal tibial osteotomy with good clinical results that achieve patellar tendon length stability and avoid patellofemoral problems.