The occurrence of patella baja can affect the biomechanics of the knee, causing anterior knee pain, patellofemoral arthritis, and reduced range of motion of the knee joint. Recently, several studies have shown that PTO increases contact pressure in the patellofemoral (PF) joint, leads to patella baja, and increases the posterior tibial slope (PTS). Depending on the osteotomy position, OWHTO can be divided into proximal tibial tubercle osteotomy (PTO) and distal tibial tubercle osteotomy (DTO). Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42021284443.Ĭonventional medial open-wedge high tibial osteotomy (OWHTO) is commonly performed for the treatment of medial compartment knee osteoarthritis (KOA) with good clinical efficacy. Nevertheless, both can significantly correct knee varus deformity and improve knee function their early knee function scores are also similar. ConclusionsĬompared with DTO, PTO is associated with a greater incidence of postoperative patella baja and increased PTS, whereas DTO is associated with more postoperative complications. Further, DTO was associated with a significantly greater number of postoperative complications ( p 0.05). There was a significant difference in the ISI, CDI, BPI, and PTS between the two groups (all p ≤ 0.05). There were no significant differences in the age or sex of included patients. ResultsĪ total of 15 retrospective studies (910 knees) were included. Outcomes of interest included the Insall-Salvati index (ISI), Caton-Deschamps index (CDI), Blackburne-Peel index (BPI), posterior tibial slope (PTS), and the Hospital for Special Surgery (HSS) knee-rating scale. Statistical analysis was performed with Stata 12.0. The Cochrane risk-of-bias tool was used to assess methodological quality. The meta-analysis was conducted using RevMan 5.2 software. The Cochrane Central Library, MEDLINE, Embase, PubMed, CNKI, and WanFang databases were systematically searched for trials comparing PTO and DTO in patients with medial compartment KOA, from inception until March 2022. This study was conducted as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The purpose of our study was to investigate which among the two is superior for medial KOA, with respect to knee joint parameters, clinical function, and complications. However, there is currently no consensus on which surgical technique is superior. The DTO osteotomy point is generally located about 0.5–1.0 cm below the tibial tubercle, and the osteotomy line points to the contralateral cortex. The PTO osteotomy point is generally located about 3–4 cm below the joint of the proximal tibia, and the osteotomy line points to the upper part of the proximal tibiofibular joint. Open-wedge high tibial osteotomy (OWHTO) is commonly performed for the treatment of medial compartment knee osteoarthritis (KOA), and is classified into proximal tibial tubercle osteotomy (PTO) and distal tibial tubercle osteotomy (DTO).
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