Knee Surg Relat Res.  2016 Dec;28(4):263-269. 10.5792/ksrr.15.051.

The SPECT/CT Evaluation of Compartmental Changes after Open Wedge High Tibial Osteotomy

• Kim TW
• Kim BK
• Kim DW
• Sim JA
• Lee BK
• Lee YS

• KMID: 2361824
• DOI: http://doi.org/10.5792/ksrr.15.051

Abstract

PURPOSE
The purpose of this study was to evaluate compartmental changes using combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT) after open wedge high tibial osteotomy (OWHTO) for providing clinical guidance for proper correction.
MATERIALS AND METHODS
Analysis was performed using SPECT/CT from around 1 year after surgery on 22 patients who underwent OWHTO. Postoperative mechanical axis was measured and classified into 3 groups: group I (varus), group II (0°-3° valgus), and group III (>3° valgus). Patella location was evaluated using Blackburne-Peel (BP) ratio. On SPECT/CT, the knee joint was divided into medial, lateral, and patellofemoral compartments and the brighter signal was marked as a positive signal.
RESULTS
Increased signal activity in the medial compartment was observed in 12 cases. No correlation was observed between postoperative mechanical axis and medial signal increase. Lateral increased signal activity was observed in 3 cases, and as valgus degree increased, lateral compartment's signal activity increased. Increased signal activity of the patellofemoral joint was observed in 7 cases, and significant correlation was observed between changes in BP ratio and increased signal activity.
CONCLUSIONS
For the treatment of medial osteoarthritis, OWHTO requires overcorrection that does not exceed 3 valgus. In addition, the possibility of a patellofemoral joint problem after OWHTO should be kept in mind.

Keyword

Knee; Osteotomy; Open wedge; Single-photon emission computerized tomography

MeSH Terms

Humans
Knee
Knee Joint
Osteoarthritis
Osteotomy*
Patella
Patellofemoral Joint
Tomography, Emission-Computed, Single-Photon