KEN OKAZAKI    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor and Division head
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Distal Tibial Tuberosity Arc Osteotomy in Open-Wedge Proximal Tibial Osteotomy to Prevent Patella Infra.
Journal	Formal name：Arthroscopy techniques Abbreviation：Arthrosc Tech ISSN code：22126287/22126287
Domestic / Foregin	Foregin
Volume, Issue, Page	8(6),pp.e655-e662
Author and coauthor	Akiyama Takenori, Osano Kei, Mizu-Uchi Hideki, Nakamura Norimasa, Okazaki Ken, Nakayama Hiroshi, Takeuchi Ryohei
Publication date	2019/06
Summary	Open-wedge high tibial osteotomy is considered to be an effective surgical intervention for medial compartmental knee osteoarthritis. However, patella infra, which has been reported to be a result of tuberosity distalization after open-wedge high tibial osteotomy, changes the native patellofemoral biomechanics. This could raise abnormal patellofemoral contact stresses, which might be the trigger of patellofemoral arthrosis. To minimize the reduction in patellar height, we have developed a technique called open-wedge distal tuberosity tibial osteotomy. The benefits of this technique include increased bone-to-bone contact of the distal tuberosity cut surface after correction by cutting an arc osteotomy around the hinge position, which is the center of rotation. This technique also provides cortical support at the anterior osteotomy site without additional bone defect and, therefore, may be advantageous against weight-bearing stress on the osteotomy site. In all, open-wedge distal tuberosity tibial osteotomy could potentially be a unique open-wedge osteotomy that eliminates the risk for postoperative patellofemoral osteoarthritis and also could theoretically encourage rapid healing of the osteotomy, which could lead to early return to full physical activity.
DOI	10.1016/j.eats.2019.02.011
PMID	31334025