We systematically reviewed the published literature
on the complications of closing wedge high tibial osteotomy for
the treatment of unicompartmental osteoarthritis of the knee. Publications
were identified using the Cochrane Library, MEDLINE, EMBASE and
CINAHL databases up to February 2012. We assessed randomised (RCTs), controlled
group clinical (CCTs) trials, case series in publications associated
with closing wedge osteotomy of the tibia in patients with osteoarthritis
of the knee and finally a Cochrane review. Many of these trials
included comparative studies (opening wedge
The purpose of this study was to evaluate 3 methods used to produce posterior tibial slope. 110 total knee arthroplasties performed during a 4 year period were included(2005 to 2009). All operations were performed by 2 surgeons. Group 1 used an extramedullary guide with a 0 degree cutting block tilted by placing 2 fingers between the tibia and the extramedullary guide proximally and three fingers distally to produce a 3 degree posterior slope (N=40). Group 2 used computer navigation to produce a 3 degree posterior slope (N=30). Group 3 used an extramedullary guide placed parallel to the anatomic axis of the tibia with a 5 degree cutting block to produce a 5 degree slope (N=40). Posterior tibial slope was measured by 2 independent blinded reviewers. The reported slope for each sample was the average of these measurements. All statistical calculations were performed using SPSS Windows Version 16.0 (SPSS Inc., IL, USA). There was excellent agreement for the mean posterior slopes measured by the 2 independent reviewers. The linear correlation constant was 0.87 (p<0.01). The paired t test showed no significant difference (p=0.82). The measurements for Group 1 (4.15±3.24 degrees) and Group 2 (1.60±1.62 degrees) were both significantly different to the ideal slope of 3 degrees (p=0.03 for Group 1 and p<0.01 for Group 2). The mean posterior tibial slope of Group 3 (5.00±2.87 degrees) was not significantly different to the ideal posterior tibial slope of 5 degrees (p=1.00). Group 2 exhibited the lowest standard deviation.Methods
Results
