L’altezza della rotula dopo osteotomia tibiale prossimale: confronto fra tecnica di addizione mediale e sottrazione laterale

The clinical and radiographic results of patients with unicompartmental osteoarthritis or axial malalignment of the knee surgically treated with two different techniques of osteotomy of the proximal tibia were analysed. The patients, matched for age, sex and deformities, were divided into two groups: 47 cases treated with closed-wedge high tibial osteotomy and 40 cases with open-wedge high tibial osteotomy. For each case the height of the patella was measured by the Caton Method before surgery and at the last follow-up (at least 1 year after surgery). The purpose of this study was to analyse and search for any possible correlation between the variation of the patella and the degree of correction of the mechanical axis. It was concluded that patellar height after final osteotomy of the proximal tibia is modified and depends on the surgical technique used. Our study has shown a more frequent loss of patellar height with open-wedge high tibial osteotomy rather than closed-wedge high tibial osteotomy, the latter followed by a rather high rate of patellar elevation.