PURPOSE: The purpose of this study was to evaluate the effect of concomitant arthroscopic lateral release (LR) in open wedge high tibial osteotomy (OWHTO) by comparing the pre- and postoperative radiological parameters of patellar position and orientation. MATERIALS AND METHODS: The study was comprised of 19 knees undergoing OWHTO and concomitant LR and 18 knees undergoing OWHTO alone. Radiological parameters for patellar position and orientation included the Caton-Deschamps index (CDI), Blackburne-Peel index (BPI), patellar tilting angle (PTA), patellar lateral shift (PLS), and patellofemoral distance (PFD), which were evaluated in the preoperative period and at one year after surgery. RESULTS: Patellar height was significantly reduced after surgery as indicated by the decrease in BPI (p=0.03) in the OWHTO/LR group, and decrease in CDI (p=0.03) and BPI (p=0.04) in the OWHTO alone group. PTA and PLS were significantly reduced after the combined OWHTO/LR procedure (p=0.04 and p=0.04, respectively). By contrast, no significant changes were detected when isolated OWHTO was performed. CONCLUSIONS: OWHTO induced a postoperative decrease in patellar height in both groups. Regarding the change in patellofemoral alignment, concomitant LR in OWHTO significantly decreased lateral patellar tilt and shift, while no significant difference in those parameters were noted in the OWHTO alone knees.
Arthroscopy ; Knee ; Osteotomy ; Preoperative Period

Constraint-induced movement therapy (CIMT) has been a well-established rehabilitative method for upper limb paralysis in patients post-stroke. In recent years, its application to lower limb paralysis (Lower limb CIMT, L-CIMT) has been reported. However, the reported intensive lower limb trainings do not seem enough to target behavioral modifications in an individual's daily life. In this study, we investigated the effects of L-CIMT including the transfer package to induce behavioral transformation in normal daily life of patients with lower limb paralysis. The L-CIMT including the transfer package was administered to three patients with chronic-phase stroke without any constraint on the healthy lower limb for 3.5 hours a day, 5 days a week for 3 weeks. As a result, standing balance and walking ability were improved immediately and within 6 months after the intervention, respectively. All three cases experienced increased daily opportunities for standing and walking. We believe that L-CIMT including the transfer package can bring both short- and long-term improvements in standing balance and walking ability. This can lead to an increase in the frequency of standing and walking in daily living, along with an expanded range of action in ADL and IADL in patients with chronic-phase stroke.

Constraint-induced movement therapy (CIMT) has been a well-established rehabilitative method for upper limb paralysis in patients post-stroke. In recent years, its application to lower limb paralysis (Lower limb CIMT, L-CIMT) has been reported. However, the reported intensive lower limb trainings do not seem enough to target behavioral modifications in an individual's daily life. In this study, we investigated the effects of L-CIMT including the transfer package to induce behavioral transformation in normal daily life of patients with lower limb paralysis. The L-CIMT including the transfer package was administered to three patients with chronic-phase stroke without any constraint on the healthy lower limb for 3.5 hours a day, 5 days a week for 3 weeks. As a result, standing balance and walking ability were improved immediately and within 6 months after the intervention, respectively. All three cases experienced increased daily opportunities for standing and walking. We believe that L-CIMT including the transfer package can bring both short- and long-term improvements in standing balance and walking ability. This can lead to an increase in the frequency of standing and walking in daily living, along with an expanded range of action in ADL and IADL in patients with chronic-phase stroke.