An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function

doi:10.13418/j.issn.1001-165x.2024.1.14

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Chinese Journal of Clinical Anatomy ›› 2024, Vol. 42 ›› Issue (1) : 77-82. DOI: 10.13418/j.issn.1001-165x.2024.1.14

An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function

Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui*

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Abstract

Objective To investigate whether the changes in patellar position affect patellofemoral joint function and functional outcomes or not. Methods Patients who underwent arthroscopy combined with high tibial osteotomy (ACHTO) from March 2018 to March 2021 were enrolled in a retrospective study. Arthroscopic diagnosis was performed during primary surgery and internal fixation removal, and the status of articular cartilage and clinical outcomes were compared. Imaging measurements were also taken to evaluate changes in patellar position. At the same time to explore the relationship between articular cartilage status and function. Results A total of 60 patients who received arthroscopy combined with high tibial osteotomy were included in this study, including 18 male patients and 42 female patients, with an average age of (58.6±7.2) years and an average follow-up time of (26.8±8.5) months. After underwent ACHTO surgery, there was no statistical difference in the patellar height index ISI, and the BPI index changed from the preoperative (0.90±0.11) to (0.81±0.13). By secondary arthroscopy, the cartilage condition of the medial femoral condyle improved from 3.81 to 3.35 (P=0.005) and that of the medial tibial plateau from 3.75 to 3.48 (P=0.005) as assessed by the ICRS scoring system. The mean ICRS score of the lateral femoral condyle decreased from 0.15 to 0.43 (P=0.004), and the mean ICRS score of the lateral tibial condyle decreased from 0.38 to 0.96 (P<0.001). The average ICRS grading of the patellar side was 2.29-2.31 and the average ICRS grading of the femoral trochlea was 2.18-2.25. Knee functional scores were significantly improved compared with those before operation. Conclusions After arthroscopy combined with high tibial osteotomy, no obvious damage or degeneration of patellofemoral cartilage is observed. Moreover, the knee function, especially the patellofemoral joint function, was not affected by the change of patellar position.

Key words

Arthroscopy combined with high tibial osteotomy; / / Patellar position; / / Articular cartilage

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Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui. An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function[J]. Chinese Journal of Clinical Anatomy. 2024, 42(1): 77-82 https://doi.org/10.13418/j.issn.1001-165x.2024.1.14

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