Introduction

To investigate the impact medial opening wedge high tibial osteotomy (MOWHTO) has on the progression of patellofemoral OA, patella height and contact pressure within the patellofemoral joint (PF).

Methods

A systematic review was conducted in January 2022 according to PRISMA guidelines. Each study was graded as per the MINORS criteria for non-randomised trials. The ICRS cartilage grade of the PF joint at the initial MOWHTO surgery and at second look surgery was compared and relative risk of progression of PF OA was calculated. Evaluation of patella height was assessed by Caton-Deschamps index, Blackburne-Peel index or Insall-Salvati ratio pre and post MOWHTO. Cadaveric studies assessing contact pressures in the PF after MOWHTO were included.

Introduction

OtisMed Shape Match ® patient specific implant cutting jigs were designed to place TKA in kinematic alignment (KA) rather than traditional mechanical alignment (MA). This product was withdrawn from the market in 2013.

It has been hypothesised that KA might lead to early implant failure. Initial evidence has not supported this.

We present 10 year outcome data for the largest single centre cohort to date.

Methodology

Between 2010 and 2013, 127 Shape Match® TKAs were implanted in 119 individuals.

Retrospective review of long leg post-operative radiographs assessed femoral mechanical anatomical angle (FMA), tibial mechanical angle (TMA), hip-knee-ankle angle (HKA), posterior tibial slope (PTS) and femoral component flexion.

Oxford Knee Scores (OKS), revision and further surgery rates were reviewed.