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Year : 2021  |  Volume : 7  |  Issue : 2  |  Page : 132-137

New measurements to determine changes after intra-articular high tibial osteotomy

1 Centre for Ilizarov Techniques, Chaudhary Hospital, Akola, Maharashtra, India
2 Department of Orthopaedics, Rural Medical College, Loni, Maharashtra, India

Correspondence Address:
Dr. Milind Chaudhary
Centre for Ilizarov Techniques in India, Chaudhary Hospital, Civil Lines, Akola - 444 001, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jllr.jllr_41_21

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Background: Most high tibial osteotomies (HTO), performed for medial compartment osteoarthritis of the knee (MCOA) are extra-articular osteotomies of the upper tibia. Recently, attention has turned to detecting and treating intra-articular deformities of the upper tibia causing MCOA. Chiba introduced the tibial condylar valgus osteotomy (TCVO) in Japan and few English language articles have described indications, surgical techniques of results of these osteotomies. Two angles commonly measure and detect the intra-articular deformity and measure the difference between preoperative and postoperative parameters: Joint line convergence angle (JLCA) and condylar plateau angle (CPA). Aims and Objectives: JLCA is relatively easy to measure as it uses clearly visible landmarks to draw tangents to femoral and tibial condyles to subtend the angle. CPA is a little difficult to measure and we found it to be less reliable in intra-observer as well as interobserver readings. Materials and Methods: We decided to measure the intra-articular deformity by using spine edge angle (SEA) and spine vertical distance (SVD) as two new measurements. These have proved to be reliable in intra as well as interobserver measurements. We compared readings of SEA and SVD in 57 patients each who had an intra-articular TCVO and also an extraarticular medial open wedge HTO (OWHTO). Results: We found a significant change between preoperative and postoperative measurements of SEA and SVD in patients who underwent TCVO, but no change in patients who underwent OWHTO. Conclusions: The two new measurements of SEA and SVD accurately measure the change in intra-articular deformity parameters in patients who undergo TCVO and are more reliable than CPA.

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