• Ricardo Hideki Yanasse, Carlos Eduardo Cavallari, Felipe Lourenço Chaud, Arnaldo José Hernandez, Roberto Ryuiti Mizobuchi, and Marcos Henrique Laraya.
• Institute of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil. ricardoyanasse@yahoo.com.br
• Sao Paulo Med J. 2009 Jan 1; 127 (1): 343934-9.

Context And ObjectiveIn the past, changes in tibial slope were not considered when planning or evaluating osteotomies, and success in high tibial osteotomy was related to the alignment and amount of femorotibial angular correction. The aim here was to measure changes in tibial slope after medial opening wedge tibial osteotomy and investigate the effect of tibial slope angle on the clinical results.Design And SettingRetrospective review study on a series of cases, at the Department of Orthopedics and Traumatology, Faculdade de Medicina de Marília (Famema), Marília, Brazil.MethodsTwenty-eight patients were studied, and a total of thirty-one knees. Lateral roentgenograms of the tibia were used pre and postoperatively to measure the tibial slope based on the proximal tibial anatomical axis. The clinical results were measured using the Lysholm knee score.ResultsThere was an average increase in tibial slope angle after surgery of 2.38 degrees (95% confidence interval: +/- 0.73 degrees ). There was no correlation (r = -0.28) between the postoperative Lysholm knee score and the difference in tibial slope angle from before to after surgery (P = 0.13).ConclusionMedial opening wedge tibial osteotomy led to a small increase in tibial slope. No significant correlation was found between increased tibial slope and short-term clinical results after high tibial osteotomy. Other clinical studies are needed in order to establish whether extension or flexion osteotomy could benefit patients with medial compartment gonarthrosis.

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