scholarly journals Effect of the Osteotomy Inclination Angle in the Sagittal Plane on the Posterior Tibial Slope of the Tibiofemoral Joint in Medial Open-Wedge High Tibial Osteotomy: Three-Dimensional Computed Tomography Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4272
Author(s):  
Jai Hyun Chung ◽  
Chong Hyuk Choi ◽  
Sung-Hwan Kim ◽  
Sung-Jae Kim ◽  
Seung-Kyu Lee ◽  
...  
Keyword(s):  
Inclination Angle ◽  
Sagittal Plane ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Medial Tibial Plateau ◽  
Tibiofemoral Joint ◽  
Posterior Tibial ◽  
Group A ◽  
Osteotomy Line ◽  
Reconstructed Model

The posterior tibial slope of the tibiofemoral joint changes after medial open wedge high tibial osteotomy (MOWHTO), but little is known about the effect of the sagittal osteotomy inclination angle on the change in the posterior tibial slope of the tibiofemoral joint. The purpose of this study was to investigate the effect of the osteotomy inclination angle in the sagittal plane on changes in the posterior tibial slope after MOWHTO by comparing how anterior and posterior inclination affect the posterior tibial slope of the tibiofemoral joint. The correlation between the osteotomy inclination angle and the postoperative posterior tibial slope angle was also assessed. Between May 2011 and November 2017, 80 patients with medial compartment osteoarthritis who underwent MOWHTO were included. The patients were divided into two groups according to the sagittal osteotomy inclination angle on the 3D reconstructed model. Patients with an osteotomy line inclined anteriorly to the medial tibial plateau line were classified into group A (58 patients). Patients with posteriorly inclined osteotomy line were classified as group P (22 patients). In the 3D reconstructed model, the preoperative and postoperative posterior tibial slope, osteotomy inclination angle relative to medial tibial plateau line in sagittal plane, and gap distance and ratio of the anterior and posterior osteotomy openings were measured. The preoperative and postoperative hip-knee-ankle angle, weight-bearing line ratio, and posterior tibial slope were also measured using plain radiographs. In the 3D reconstructed model, the postoperative posterior tibial slope significantly increased in group A (preoperative value = 9.7 ± 2.9°, postoperative value = 10.7 ± 3.0°, p < 0.001) and decreased in group P (preoperative value = 8.7 ± 2.7°, postoperative value = 7.7 ± 2.7°, p < 0.001). The postoperative posterior tibial slope (group A = 10.7 ± 3.0°, group P = 7.7 ± 2.7°, p < 0.001) and posterior tibial slope change before and after surgery (group A = 1.0 ± 0.8°, group P = −0.9 ± 0.8°, p < 0.001) also differed significantly between the groups. The Pearson correlation coefficient was 0.875 (p < 0.001) for the osteotomy inclination angle, and multivariate regression analysis showed that the only significant factor among the variables was the sagittal osteotomy inclination angle (β coefficient = 0.216, p < 0.001). The posterior tibial slope changed according to the osteotomy inclination angle in the sagittal plane after MOWHTO. The postoperative posterior tibial slope tended to increase when the osteotomy line was inclined anteriorly with respect to the medial tibial plateau line but decreased when the osteotomy line was inclined posteriorly. To avoid inadvertent change of posterior tibial slope, close attention needs to be paid to maintaining the sagittal osteotomy line parallel to the medial joint line during MOWHTO.

scholarly journals The effect of the sagittal plane osteotomy inclination on the posterior tibial slope in medial open wedge HTO: experimental study with a square column model

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sang Won Moon ◽  
Ji Young Ryu ◽  
Sung-Jae Lee ◽  
Sang Won Woo ◽  
Sin Hyung Park ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
3D Printer ◽  
Open Wedge ◽  
Correction Angle ◽  
Posterior Slope ◽  
Column Model ◽  
Posterior Tibial ◽  
Open Wedge Hto

Abstract Background Medial open-wedge high tibial osteotomy (HTO) is an effective and safe treatment method for medial osteoarthritis of the knee. However, unintended changes in the posterior tibial slope (PTS) may occur. Several factors cause PTS alterations after medial open-wedge HTO; however, research on sagittal-plane osteotomy inclination (SPOI) in relation to the PTS is sparse. The purpose of this study was to evaluate whether the SPOI affects changes in the PTS after medial open-wedge HTO. The hypothesis was that an SPOI parallel to the PTS causes no change in the PTS after medial open-wedge HTO. Methods A square column model with a 10° posterior slope was produced using two three-dimensional (3D) programs and a 3D printer. Then, a series of medial open-wedge HTO procedures was performed on the square column model through virtual simulation using the two 3D programs, and an actual simulation was conducted using a 3D printer, a testing machine and a measurement system. The SPOI was divided into four types: ① SPOI 20° (posterior-inclined 10° osteotomy), ② SPOI 10° (osteotomy parallel to posterior slope), ③ SPOI 0° (anterior-inclined 10° osteotomy), and ④ SPOI − 10° (anterior-inclined 20° osteotomy). The correction angle was increased at intervals of 5° from 0° to 30°. The change in posterior slope was measured in the sagittal plane. Results The posterior slope was increased in SPOI 20° (posterior-inclined 10° osteotomy), maintained in SPOI 10° (osteotomy parallel to posterior slope), and decreased in SPOI 0° (anterior-inclined 10° osteotomy) and SPOI − 10° (anterior-inclined 20° osteotomy) based on the correction angle. Conclusions In this study using a square column model, the SPOI affected the change in the PTS, and an SPOI parallel to the PTS caused no change in the PTS after medial open-wedge HTO.

scholarly journals The Influence of Posterior Tibial Slope on the Mid-term Clinical Effect of Medial-pivot Knee Prosthesis

2021 ◽  
Author(s):  
Weipeng Shi ◽  
Yaping Jiang ◽  
Xuan Zhao ◽  
Haining Zhang ◽  
Yingzhen Wang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Knee Joint ◽  
Knee Prosthesis ◽  
Tibial Slope ◽  
Joint Line ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Medial Pivot ◽  
Group A ◽  
The Stability

Abstract Objective: To evaluate the effect of posterior tibial slope (PTS) on the mid-term clinical outcome following a medial-pivot (MP) prosthesis. Method: 233 patients from this hospital, who had undergone a total knee arthroplasty (TKA) with MP prosthesis between January 2015 and December 2015, were retrospectively included in this study. They were divided 3 groups according to postoperative PTS: A ≤ 5°; B 5-7° and C ≥ 7°. Multiple assessments were made on the patient postoperatively and recorded in the three groups, the measurements of this study included: The range of motion (ROM), knee scoring system (KSS), Western Ontario and McMaster universities osteoarthritis index (WOMAC), posterior condylar offset (PCO), joint line height and postoperative complications. Results: The average post-operative ROM for groups B and C were 108°and 110°respectively, this was significantly higher than that of group A (98°, P < 0.001). The WOMAC scores of patients in group C were significantly lower than those in groups A and B (p < 0.05). However, there were no significant differences in KSS, PCO, joint line height among the 3 groups (P>0.05). Only 2 cases of postoperative complications occurred in group C, these were recovered after operation. Conclusion: With an increase to PTS, the postoperative ROM can be significantly increased for the patient, however, the knee joint function will not be significantly improved, and the stability of knee joint will not be affected within the appropriate PTS.

scholarly journals Influence of posterior tibial slope on knee flexion in posterior stabilized fixed bearing primary total knee arthroplasty

2020 ◽  
Vol 6 (3) ◽  
pp. 487
Author(s):  
Sandeep Kumar Kanugula ◽  
Mallesh Rathod ◽  
Venugopal S. M. ◽  
Mohan Babu Lebaku
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Group A ◽  
Total Knee ◽  
Pcl Substituting

<p class="abstract"><strong>Background:</strong> The goal of total knee arthroplasty (TKA) is to relieve pain and maintain stable range of motion (ROM) for day to day activities. Among the various factors, posterior tibial slope slope (PTS) may play an important role in achieving good postoperative knee flexion. Our study aims to know the effectiveness of PTS on the ROM of the knee in a posterior cruciate ligament (PCL)-substituting TKA.</p><p class="abstract"><strong>Methods:</strong> A total of 125 unilateral PCL-substituting TKA’s were included in the study. Based on postoperative PTA which was measured on lateral radiograph, patients were divided into 3 groups, Group A (PTS of ≤2) comprise of 24 patients. Group B consists of 91 patients (PTS of 3 to 7). Group C includes 10 patients (PTS of 8 or more). Functional outcome was measured by using knee society score (KSS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) which were evaluated preoperatively and at 18months post operatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean postop ROM was 92.91 ± 10.632; 107.24±10.905; 107.49±13.944 in group A, B, C respectively which was significantly related to mean postop PTS (0.74; 5.62; 9.87 in group A, B, C respectively) (P&lt;0.05). Functional outcome was measured by KSS and WOMAC which showed no significant difference pre and postoperatively.</p><p class="abstract"><strong>Conclusions:</strong> The results of our study validate the hypothesis that a positive correlation exists between the postoperative flexion and PTS in the PCL-substituting TKA, an increase in PTS can lead to a greater degree of the knee flexion for every extra degree of PTS.</p><p> </p>

Steep Posterior Tibial Slope, Anterior Tibial Subluxation, Deep Posterior Lateral Femoral Condyle, and Meniscal Deficiency Are Common Findings in Multiple Anterior Cruciate Ligament Failures: An MRI Case-Control Study

2019 ◽  
Vol 47 (2) ◽  
pp. 285-295 ◽  
Author(s):  
Alberto Grassi ◽  
Luca Macchiarola ◽  
Francisco Urrizola Barrientos ◽  
Juan Pablo Zicaro ◽  
Matias Costa Paz ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Tibial Slope ◽  
Lateral Femoral Condyle ◽  
Posterior Tibial Slope ◽  
Control Group ◽  
Medial Tibial Plateau ◽  
Posterior Tibial ◽  
Anterior Tibial

Background: Tibiofemoral anatomic parameters, such as tibial slope, femoral condyle shape, and anterior tibial subluxation, have been suggested to increase the risk of anterior cruciate ligament (ACL) reconstruction failure. However, such features have never been assessed among patients experiencing multiple failures of ACL reconstruction. Purpose: To compare the knee anatomic features of patients experiencing a single failure of ACL reconstruction with those experiencing multiple failures or with intact ACL reconstruction. Study: Case-control study; Level of evidence, 3. Methods: Twenty-six patients who experienced failure of revision ACL reconstruction were included in the multiple-failure group. These patients were matched to a group of 25 patients with failure of primary ACL reconstruction and to a control group of 40 patients who underwent primary ACL reconstruction with no failure at a minimum follow-up of 24 months. On magnetic resonance imaging (MRI), the following parameters were evaluated: ratio between the height and depth of the lateral and medial femoral condyles, the lateral and medial tibial plateau slopes, and anterior subluxation of the lateral and medial tibial plateaus with respect to the femoral condyle. The presence of a meniscal lesion during each procedure was evaluated as well. Anatomic, demographic, and surgical characteristics were compared among the 3 groups. Results: The patients in the multiple-failure group had significantly higher values of lateral tibial plateau slope ( P < .001), medial tibial plateau slope ( P < .001), lateral tibial plateau subluxation ( P < .001), medial tibial plateau subluxation ( P < .001), and lateral femoral condyle height/depth ratio ( P = .038) as compared with the control group and the failed ACL reconstruction group. Moreover, a significant direct correlation was found between posterior tibial slope and anterior tibial subluxation for the lateral ( r = 0.325, P = .017) and medial ( r = 0.421, P < .001) compartments. An increased anterior tibial subluxation of 2 to 3 mm was present in patients with a meniscal defect at the time of the MRI as compared with patients who had an intact meniscus for both the lateral and the medial compartments. Conclusion: A steep posterior tibial slope and an increased depth of the lateral femoral condyle represent a common finding among patients who experience multiple ACL failures. Moreover, higher values of anterior subluxation were found among patients with repeated failure and those with a medial or lateral meniscal defect.

Influence of posterior tibial slope on three-dimensional femorotibial alignment under weightbearing conditions in healthy Japanese elderly people

2021 ◽  
pp. 1-12
Author(s):  
Ryota Katsumi ◽  
Takashi Sato ◽  
Tomoharu Mochizuki ◽  
Satoshi Watanabe ◽  
Osamu Tanifuji ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
External Rotation ◽  
Weight Bearing ◽  
Linear Regression Analysis ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Rotational Alignment ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Japanese Elderly

BACKGROUND: Assessment of three-dimensional (3D) femorotibial alignment is essential for successful knee osteoarthritis treatment in the elderly. The complex morphology of the posterior tibial slope (PTS) might have an influence on sagittal and rotational alignment and the positional relationship between the femur and tibia in the anterior–posterior (AP) direction under weight-bearing conditions. OBJECTIVE: This study aimed to clarify the association between the PTS and 3D femorotibial alignment under weight-bearing conditions in healthy Japanese elderly individuals. METHODS: We investigated the 3D femorotibial alignment of 110 lower extremities of 55 healthy individuals (26 women, 29 men, mean age: 70 ± 6 years). Using our previously reported 3D-to-2D image registration technique, we evaluated the 3D hip-knee-ankle angle (3DHKA) in the sagittal plane, rotational alignment, and the distance between the femoral and tibial origins in the AP direction (tibial AP position) as femorotibial alignment parameters under weight-bearing conditions. We assessed the medial and lateral PTS and their angular difference (PTS difference) as PTS parameters. Stepwise multiple linear regression analysis was performed using PTS parameters and other possible confounders (age, sex, height, and weight) as the independent variables and femorotibial alignment parameters as the dependent variable. RESULTS: Weight (𝛽 = 0.393, p < 0.001) and lateral PTS (𝛽 = 0.298, p < 0.001) were the predictors associated with 3DHKA in the sagittal plane. Lateral PTS (𝛽 = 0.304, p = 0.001) was the only predictor associated with the tibial AP position. Sex (𝛽 = −0.282, p = 0.002) and PTS difference (𝛽 = −0.231, p = 0.012) were associated with rotational alignment. CONCLUSIONS: We found that a steeper lateral PTS resulted in a more flexed knee and anterior tibia. The PTS difference was positively correlated with tibial external rotation. Our data could be used as the standard reference for realignment surgery to ensure PTS is appropriately maintained.

scholarly journals Correction to: The effect of the sagittal plane osteotomy inclination on the posterior tibial slope in medial open wedge HTO: experimental study with a square column model

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sang Won Moon ◽  
Ji Young Ryu ◽  
Sung-Jae Lee ◽  
Sang Won Woo ◽  
Sin Hyung Park ◽  
...  
Keyword(s):  
Experimental Study ◽  
Sagittal Plane ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Open Wedge ◽  
Column Model ◽  
Posterior Tibial ◽  
Open Wedge Hto

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals Knees with Smaller Posterior Tibial Slope And More Concave Medial Tibial Plateau Are At Higher Risk Of Isolated Meniscal Injuries

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0046
Author(s):  
Martha Murray ◽  
Ata Kiapour ◽  
Samuel Barnett
Keyword(s):  
Tibial Plateau ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Meniscus Tear ◽  
Medial Tibial Plateau ◽  
Shear Forces ◽  
Anatomical Features ◽  
Posterior Tibial ◽  
Increased Risk ◽  
Meniscus Tears

Objectives: Meniscal injuries are extremely common. Several anatomical features of the knee, including the tibial plateau morphology, have been shown to influence knee biomechanics and the risk of ligamentous injuries. Little is known, however, how these morphological features influence the risk of isolated meniscal injuries in the ACL intact knee. In the current study, we used MRI and 3D image analysis to investigate anatomical variables of knees in patients with and without isolated meniscus tears. We hypothesized that there are differences in slopes and concavity of the tibial plateau between patients with isolated meniscus tears and matched normal controls. Methods: 65 subjects with first-instance isolated medial or lateral meniscal injuries requiring surgical fixation (Age: 15 +/- 2 years, BMI: 23.2 +/- 3.7 Kg/m2; 43% females) were matched to 65 subjects with normal knees and no prior injuries (Age: 15 +/- 2 years, BMI: 23.1 +/- 3.8 Kg/m2; 43% females) based on age, BMI and sex. Sagittal Proton Density SPACE MR images (preoperative for injured group) were used to measure the posterior slope of the medial (MTS) and lateral (LTS) tibial plateau, coronal slope of the tibial plateau (CTS), and the maximum depth of the medial tibia plateau (MTD, as a measure of medial tibial plateau concavity), following established techniques-Figure 1. Two-sample t-test was used to compare the quantified anatomical features between the cases and matched controls. Results: There were no differences in age (p = 0.999), sex distribution (p = 0.999) and BMI (p = 0.963) between the two cohorts. Compared to matched controls, patients with isolated meniscal tears had lower LTS (3.6 +/- 3.2 vs 5.6 +/- 3.0 degrees; p < 0.001), lower MTS (3.4 +/- 2.9 vs 4.9 +/- 2.5 degrees; p = 0.001) and deeper MTD (2.4 +/- 0.8 vs 1.5 +/- 0.8 mm; p < 0.001). There was no difference in CTS between the groups (3.6 +/- 1.6 vs 3.9 +/- 2.2 degrees; p = 0.300). Conclusion: This study suggests that subjects with isolated meniscus tear have a lower posterior tibial slope and a deeper MTD (more concave medial tibial plateau) than matched population who do not have a meniscus tear. This is contrary to what is known for ACL tears, where a higher posterior tibial slope and a shallower MTD have been associated with an increased risk of ACL tear. During load-bearing activities, in particular high impact movements such as jumping, increased tibial slope and decreased MTD have shown to result in greater anterior shear forces across the knee. In contrast, the less sloped and more concave plateau will experience lower shear forces but more compression, which could be detrimental to the meniscus. This study provides preliminary evidence suggesting a link between tibial plateau morphology and risk of isolated meniscal injuries. Further mechanistic studies are required to better understand the interaction between knee morphology, meniscal loading and subsequent risk of injury. [Figure: see text]

scholarly journals The influence of posterior tibial slope on the mid-term clinical effect of medial-pivot knee prosthesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weipeng Shi ◽  
Yaping Jiang ◽  
Xuan Zhao ◽  
Haining Zhang ◽  
Yingzhen Wang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Knee Joint ◽  
Knee Prosthesis ◽  
Tibial Slope ◽  
Joint Line ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Medial Pivot ◽  
Group A ◽  
The Stability

Abstract Objective To evaluate the effect of posterior tibial slope (PTS) on the mid-term clinical outcome following a medial-pivot (MP) prosthesis. Method Two hundred thirty-three patients from The Affiliated Hospital of Qingdao University, who had undergone a total knee arthroplasty (TKA) with MP prosthesis between January 2015 and December 2015, were retrospectively included in this study. They were divided into 3 groups according to postoperative PTS: A ≤ 5°; B 5-7°; and C ≥ 7°. Multiple assessments were made on the patient postoperatively and recorded in the three groups, the measurements of this study included: the range of motion (ROM), knee scoring system (KSS), Western Ontario and McMaster universities osteoarthritis index (WOMAC), posterior condylar offset (PCO), joint line height, and postoperative complications. Results The average post-operative ROM for groups B and C were 108° and 110° respectively; this was significantly higher than that of group A (98°, P < 0.001). The WOMAC scores of patients in group C were significantly lower than those in groups A and B (P < 0.05). However, there were no significant differences in KSS, PCO, and joint line height among the 3 groups (P > 0.05). Only 2 cases of postoperative complications occurred in group C, these were ameliorated after operation. Conclusion With an increase to PTS, the postoperative ROM can be significantly increased for the patient. However, the knee joint function will not be significantly improved, and the stability of knee joint will not be affected when within the limits of appropriate PTS.

scholarly journals The Effect of Sagittal Plane Inclination on Posterior Tibial Slope in Medial Open Wedge HTO – Experimental Study With a Square Column Model-

2020 ◽  
Author(s):  
Sang Won Moon ◽  
Ji Young Ryu ◽  
Sung Jae Lee ◽  
Sang Won Woo ◽  
Sin Hyung Park ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Testing Machine ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Tibial Osteotomy ◽  
3D Printer ◽  
Open Wedge ◽  
Posterior Slope ◽  
Column Model ◽  
Posterior Tibial

Abstract Background: Medial open-wedge high tibial osteotomy (MOWHTO) is an effective and safe treatment method in medial osteoarthritis of knee. However, it may accompany unintended change of posterior tibial slope (PTS). Several factors are known to cause PTS change after MOWHTO. However, there is a lack of research on the sagittal plane osteotomy inclination (SPOI). The purpose of this study was to evaluate that SPOI affected the change in PTS. The hypothesis was that parallel SPOI causes no PTS change after MOWHTO. Methods:A square column model with a 10° posterior slope was produced by two 3D programs and a 3D printer. A series of MOWHTO was performed on a square column model through virtual simulation using two 3D programs and an actual simulation using a 3D printer, a testing machine and a measurement system. The SPOI was divided into 4 types: ① parallel SPOI plus 10° (SPOI: 20°), ② parallel SPOI (SPOI: 10°), ③ perpendicular SPOI (SPOI: 0°), and ④ perpendicular SPOI minus 10° (SPOI: -10°). The correction angle was increased by 5° from 0° to 30°. The change of the posterior slope was measured in sagittal plane.Results: The posterior slope was increased in the parallel SPOI plus 10° (SPOI: 20°). It was maintained in the parallel SPOI (SPOI: 10°) and decreased in the perpendicular SPOI (SPOI: 0°) and perpendicular SPOI minus 10° (SPOI: -10°).Conclusion: SPOI affected the change in PTS. Parallel SPOI causes no PTS change after MOWHTO.

scholarly journals BIPLANAR OPEN WEDGE HIGH TIBIAL OSTEOTOMY IN THE MEDIAL COMPARTMENT OSTEOARTHRITIS OF THE KNEE JOINT: COMPARISON BETWEEN THE AESCULAAND TOMOFIX PLATE AT ORTHOPAEDICS DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR.

2020 ◽  
pp. 68-70
Author(s):  
Rakesh Ramdayal Singh ◽  
Yogesh Kumar ◽  
Maseeh Azam ◽  
D. K. Singh ◽  
Debarshi Jana
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Posterior Tibial ◽  
Wedge High Tibial Osteotomy ◽  
Group A ◽  
Tomofix Plate

Background: The purpose of this study was to compare the results of Aescula and TomoFix plates used for biplanar open wedgehigh tibial osteotomy in medial osteoarthritis of the knee joint with varus deformity. Methods: A consecutive series of 50 cases of biplanar open wedge high tibial osteotomy were evaluated retrospectively. GroupA contained 25 cases treated by using the Aescula plate, and group T contained 25 cases treated by using the TomoFix plate. Full weight-bearing was permitted at 6 weeks after surgery in group A and at 2 weeks in group T. Clinical evaluations were performed at the final follow-up by using postoperative knee scores and functional scores. Radiographic analysis included postoperative mechanical femur-tibia angle, change in posterior tibial slope angle, and complications related to implants. The mean follow-up periods were 30 months in group A and 26 months in group T. Results: The knee and functional scores were improved at the final follow-up in both groups (p< 0.05), but no differences wereobserved between the two groups (p> 0.05). An acceptable correction angle was obtained in 52% of group A and in 84% of group T (p = 0.015). Change in posterior tibial slope angle was larger in group A than in group T (p< 0.001), showing better maintenance of posterior tibial slope in group T. In group A, there were 3 cases of screw loosening and 4 cases of delayed union. In addition, there were residual varus deformities in 7 cases (6 in group A and 1 in group T). Conclusions: This study shows that firm fixation using a TomoFix plate for open wedge high tibial osteotomy produces better radiologic results and a low complication rate than those of the Aescula spacer plate.

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