BACKGROUND: An excessive posterior tibial slope (PTS) is a risk factor for anterior cruciate ligament (ACL) rupture or rerupture, and it can be managed by an anterior closing wedge high tibial osteotomy (ACW-HTO). The effect of slope-changing osteotomies on patellar height is poorly described after infratuberosity ACW-HTO. PURPOSE: To assess the effect of ACW-HTO on patellar height using an infratuberosity approach. STUDY DESIGN: Case series
Level of evidence, 4. METHODS: Patients who underwent ACW-HTO between January 2019 and March 2024 were assessed for eligibility. Among 98 cases, 94 knees were analyzed with a complete radiographic assessment for the patellar height evaluation. Patellar height was measured on lateral radiographs according to the Caton-Deschamps index (CDI), Insall-Salvati index (ISI), and Blackburne-Peel index (BPI). The change in patellar height was assessed postoperatively, as were the rates of cases with a postoperative difference <
0.3, <
0.5, or >
0.5 points of the respective index. The change in patellar height category (baja, normal, or alta) after correction of the PTS was also evaluated. RESULTS: In univariate analysis, no significant difference was found between pre- and postoperative radiographs for the patellar height indices (differences for ISI: +0.1 ± 0.1, CONCLUSION: Infratuberosity ACW-HTO for tibial slope correction did not lead to significant changes in patellar height. However, slight variations in both directions were possible in a small portion of patients.