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Knee Surgery, Sports Traumatology, Arthroscopy

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01-09-2007 | Knee

Patellofemoral contact pressure following high tibial osteotomy: a cadaveric study

Authors: Karl Stoffel, Craig Willers, Omar Korshid, Markus Kuster

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2007

Abstract

Patella infera is a known complication of high tibial osteotomy (HTO) that can cause anterior knee pain due to excessive stresses associated with abnormal patellofemoral (PF) joint biomechanics. However, the translation of these abnormal biomechanics to native cartilage pressure has not been explored. The present study was designed to compare the PF contact pressures of three different HTOs in a human cadaveric model of valgus tibiofemoral correction. Nine fresh cadaveric knees underwent (1) medial opening wedge (OWHTO) with a proximal tuberosity osteotomy (PTO), (2) OWHTO with a distal tuberosity osteotomy (DTO), and (3) a lateral closing wedge (CWHTO). The specimens were mounted in a custom knee simulation rig, with muscle forces being simulated using a pulley system and weights. The PF contact pressure was recorded using an electronic pressure sensor at 15°, 30°, 60°, 90°, and 120° of knee flexion, with results of the intact knees obtained as relative control. Compared to the intact knee, the DTO OWHTO and CWHTO did not significantly (P > 0.05) influence PF pressure at any flexion angle. On the other hand, PTO OWHTO lead to a significant elevation in PF cartilage pressure at 30° (P < 0.05), 60° (P < 0.005), and 90° (P < 0.0005) knee flexion. We conclude from these results that DTO OWHTO maintains normal joint biomechanics and has no significant effect on PF cartilage pressure. In patients who complain of pre-existing anterior knee pain, DTO OWHTO or CWHTO should be considered.

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Title: Patellofemoral contact pressure following high tibial osteotomy: a cadaveric study
Authors: Karl Stoffel
Craig Willers
Omar Korshid
Markus Kuster
Publication date: 01-09-2007
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2007
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-007-0297-9

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Patellofemoral contact pressure following high tibial osteotomy: a cadaveric study

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