Affiliations: [a] Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan | [b] Department of Orthopaedic Surgery, Ni-noji Onsen Hospital, Niigata, Japan | [c] Graduate School of Science and Technology, Niigata University, Niigata, Japan
Correspondence:
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Corresponding author: Osamu Tanifuji, Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata 951-8510, Japan. Tel.: +81 25 227 2272; Fax: +81 25 227 0782; E-mail: tanifuji@med.niigata-u.ac.jp
Abstract: BACKGROUND:Closed-wedge high tibial osteotomy (CWHTO) with a fibular osteotomy (FO) causes medial joint space widening in the knee. However, the effect of FO on the joint space width remains unclear. OBJECTIVE:This study aimed to examine the effect of FO on the knee in HTO. METHODS:A compression load test was performed on two amputated human limbs under four conditions: (1) normal (without any osteotomy), (2) open-wedge HTO (OWHTO), (3) OWHTO with FO, and (4) CWHTO. The contact area of the femoral and tibial cartilages and the medial and lateral joint space widths in each condition were evaluated using a motion capture system with computed tomography (CT) and magnetic resonance imaging (MRI) data. RESULTS:The contact area increased on the lateral side after OWHTO, which increased more on the lateral side with a concomitant decrease on the medial side in both subjects when FO was added to OWHTO. An increase in the medial joint space width and a decrease on the lateral side were seen in both OWHTO with FO and CWHTO. CONCLUSIONS:The contact area and joint space widths are affected by the FO, and the effect is more pronounced than the way of HTO (OWHTO or CWHTO).
Keywords: Knee, high tibial osteotomy, tibia, fibular osteotomy
