Knee kinematics are variously influenced by different correction angles in high tibial osteotomy (HTO)

Literature reveals good to excellent data concerning patient satisfaction, as well as long-term outcomes after high tibial osteotomy (HTO). These results might be influenced by changes of knee kinematics through the procedure. However, exact influence of HTO on tibiofemoral kinematics remains unknown so far.

We conducted this study on 10 knees of Thiel embalmed whole cadavers. Knee kinematics were assessed by a navigation device before HTO, after medial open-wedge HTO of 5°, respectively after medial open-wedge HTO of 10°.

Results revealed a significant femoral rollback/tibial internal rotation at increasing knee flexion from 80° after medial open-wedge HTO of 5° and 10°. Lesser femoral rollback/tibial internal rotation was seen after 5° HTO compared to 10° HTO until knee flexion of 70°.

Results reveal a significant change of tibiofemoral kinematics only after knee flexion of 80° and more, independently from the degree of tibial osteotomy. Adjacent structures, especially the ACL, seem thus more strained by sagittal slope changes rather than changes in coronal leg axis. HTO leads to changes in knee kinematics at flexion degrees of 80 and more. To what extent this influences adjacent structures like the ACL or meniscus should be further investigated.