DISCUSSION:
Patella baja is a well known complication of high tibial osteotomies, especially opening wedge osteotomies. This procedure raises the tibiofemoral joint line and can cause retropatellar scarring and tendon contracture, decreasing the distance of the patellar tendon from the inferior joint line.
Wright et al found that the patellar height after opening wedge medial tibial osteotomies decreased the patellar height in 100% of their patients. They explain that the decrease in distance between the patella and the tibiofemoral joint line following medial opening wedge proximal tibial osteotomy is a function of joint line elevation. Their results are important when considering possible future TKA in these patients, as patella baja may have deleterious effects on patellofemoral biomechanics for future procedures.
Kolb et al studied the short-term results of opening-wedge high tibial osteotomies with locked plate fixation for patients with medial compartment arthrosis. Their results suggestted that opening-wedge high tibial osteotomy for presurgical varus deformity allowed for good short-term results and correction of the deformity.
1.
Wright JM, Heavrin B, Begg M, Sakyrd G, Sterett W. Observations on patellar height following opening wedge proximal tibial osteotomy. Am J Knee Surg. 2001 Summer;14(3):163-73.
PMID:11491427 (Link to Abstract)
2.
Kolb W, Guhlmann H, Windisch C, Kolb K, Koller H, Grützner P. Opening-wedge high tibial osteotomy with a locked low-profile plate. J Bone Joint Surg Am. 2009 Nov;91(11):2581-8.
PMID:19884431 (Link to Abstract)