The Coronal Plane High Tibial Osteotomy. Part I: A Clinical and Radiographic Analysis of Intermediate Term Outcomes

HSS Journal

Stephen Fealy, MD
Stephen Fealy, MD

Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College

Thomas L. Wickiewicz, MD
Thomas L. Wickiewicz, MD

Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor of Clinical Orthopedic Surgery, Weill Cornell Medical College

Keith M. Baumgarten, MD
Orthopedic Institute, Sports Medicine and Shoulder Surgery Section, Sioux Falls, SD

Stephen Lyman, PhD
Hospital for Special Surgery, Department of Epidemiology

The coronal plane high tibial osteotomy is a novel technique that is used to treat tibiofemoral malalignment.  The authors hypothesize that the coronal plane high tibial osteotomy is: 1) efficacious in treating both varus and valgus tibiofemoral malalignment; 2) does not alter the slope of the proximal tibia; and 3) does not alter the relationship between the patella and tibial tubercle.

A retrospective review of 25 patients with tibiofemoral malalignment (19 varus / 6 valgus) treated with a coronal plane osteotomy with a minimum of two year follow up was performed.  A Kaplan-Meyer Survival Curve was performed using knee arthroplasty and a HSS knee score < 70 as failure criteria.  The Insall-Salvati ratio and the proximal tibial slope were measured.  A p-value of 0.05 was considered significant.

At 60 month follow-up, knees with initial varus malalignment had an 84 percent survival rate using both knee arthroplasty and the HSS score as endpoints.  Knees with initial valgus malalignment had an 84 and 60 percent survival rate using knee arthroplasty and the HSS score as endpoints, respectively.  There was no statistically significant change in the Insall-Salvati ratio and proximal tibial slope after coronal plane osteotomy.

The coronal plane osteotomy is efficacious in treating varus and valgus tibiofemoral malalignment and does not alter the patellar-tibial tubercle relationship or the posterior tibial slope.

This article appears in HSS Journal: Volume 3, Number 2.
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About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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