Abstract
Medial open wedge high tibial osteotomy (MOWHTO) is a commonly performed procedure
for symptomatic medial compartment osteoarthritis (OA). However, little is known about
its effects on ipsilateral ankle or hindfoot. The aim of our study was to determine
the incidence of ankle or hindfoot problems after MOWHTO and examine its association
with radiological indices. Thirty-five knees (32 patients) undergoing navigated MOWHTO
were evaluated for the presence of new-onset ankle or hindfoot symptoms after surgery.
Pre- and postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA),
and tibial plafond inclination (TPI) were measured and compared on standing lower
limb alignment radiographs. The mean postoperative change in HKA angle, MPTA, and
TPI was 8.8°, 7.0°, and 8.4°, respectively. New-onset unexplained ankle or hindfoot
symptoms were seen in 20% of the cases after surgery. Postoperative change in TPI
was significantly greater in symptomatic patients as compared with asymptomatic ones
(12.8° ± 4.9° vs. 8.1° ± 4.8°, p = 0.03). The odds ratio (OR) for developing ankle or hindfoot symptoms in cases with
≥ 10° change in TPI postoperatively was 10.8 (p = 0.04). Ankle or hindfoot symptoms were successfully managed with conservative treatment
in all cases.
Keywords
high tibial osteotomy - open wedge - navigated - tibial plafond inclination - ankle
joint line obliquity
