Article

Medial opening wedge high tibial osteotomy is a surgical procedure intended to
redistribute loads on the knee in patients with medial compartment knee
osteoarthritis (OA). The surgery may affect moments in multiple planes during
ambulation, with potential beneficial or detrimental effects on joint loads. The
objective of this study was to investigate three-dimensional external knee
moments before and after medial opening wedge high tibial osteotomy during level
walking and during stair ascent. Fourteen patients with varus alignment and
osteoarthritis primarily affecting the medial compartment of the tibiofemoral
joint were assessed. Three-dimensional motion analyses during level walking and
stair ascent was evaluated using inverse dynamics before, 6 and 12 months after
surgery. Mean changes at 12 months suggested decreases in the peak knee
adduction, flexion and internal rotation moments, with standardized response
means ranging from 0.15 to 2.54. These decreases were observed despite increases
in speed. Changes in alignment were associated with changes in the adduction and
internal rotation moments, but not the flexion moment. Both pre- and
postoperatively, the peak knee adduction moment was significantly lower (p=0.001)
during stair ascent than during level walking, while the flexion and internal
rotation moments were significantly higher (p<0.01). There were no changes in the
knee moments on the non-surgical limb. Medial opening wedge high tibial osteotomy
is associated with sustained
(12 months) changes in knee moments in all three
planes of motion during ambulation, suggesting substantial alterations of the
loads on the knee during ambulation.
CI - Copyright (c) 2015 Elsevier B.V. All rights reserved.

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