Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy
Purpose This study aimed at determining whether overcorrection after open wedge high tibial osteotomy (OWHTO) would be predicted by the magnitude of preoperative medial and lateral coronal soft tissue laxity around the knee joint. Methods Overall, 68 knees of 62 patients who underwent OWHTO for prim...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020-10, Vol.28 (10), p.3164-3172 |
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| creator | Park, Jun-Gu Kim, Jong-Min Lee, Bum-Sik Lee, Sang-Min Kwon, Oh-Jin Bin, Seong-Il |
| description | Purpose
This study aimed at determining whether overcorrection after open wedge high tibial osteotomy (OWHTO) would be predicted by the magnitude of preoperative medial and lateral coronal soft tissue laxity around the knee joint.
Methods
Overall, 68 knees of 62 patients who underwent OWHTO for primary medial osteoarthritis were retrospectively reviewed. The mechanical hip–knee–ankle (HKA) axis, weight-bearing line (WBL) ratio, medial proximal tibial angle (MPTA), joint line obliquity, coronal subluxation, and joint line convergence angle (JLCA) were measured on full-weight-bearing long-standing HKA radiographs preoperatively and at 1 year postoperatively. The varus valgus stress angle was measured on preoperative radiographs. The correction amount due to soft tissue factors was calculated as the difference between the WBL ratio on postoperative 1-year radiographs and that on virtually corrected preoperative radiographs with the same amount of MPTA at 1 year postoperatively. The patients were grouped according to the presence or absence of a ≥ 10% overcorrection of WBL ratio (overcorrection or expected correction). Multiple logistic regression analysis was performed to identify the preoperative risk factors of overcorrection.
Results
The average WBL ratio was corrected from 19.0 ± 13.5% preoperatively to 61.6 ± 9.1% postoperatively (
P
10% was confirmed in 17 patients (28%). The preoperative JLCA and valgus stress angle were significantly greater in the overcorrection group than in the expected correction group: 5.0 ± 1.7° vs. 3.4 ± 1.9° (
P
= 0.003) and 2.4 ± 1.0° vs. 1.3 ± 1.2° (
P
= 0.002), respectively. Among the radiologic parameters, the presence of both ≥ 4° JLCA and ≥ 1.5° valgus stress angle was the only significant risk factor for overcorrection from soft tissue factors (
P
= 0.006; odds ratio, 30.2).
Conclusions
The magnitude of both medial and lateral coronal soft tissue laxity was a predictor of overcorrection from soft tissue factors after OWHTO. Overcorrection was more likely to occur in cases with both ≥ 4° JLCA and ≥ 1.5° valgus stress angle.
Level of evidence
III. |
| doi_str_mv | 10.1007/s00167-019-05805-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2320376575</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2320376575</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-c4927c6922c67f4d7225687f3139f6d7a577e53e091903eedffa4d7d2412b76d3</originalsourceid><addsrcrecordid>eNp9kT1PHDEQhi0EguPjD1BEltKk2eCP9c66RIgkSEhpktry2bOH0d76YnsJ9-_jy0GQUlCNZT_zjDUvIZecfeaMwVVmjHfQMK4bpnqmmv6ALHgrZQOyhUOyYLoVjWCqOyGnOT8yVo-tPiYnkkPPQcOCzHeTS2gzerpJGDeYbAlPSNfogx2pnTwdbam3Y63PoWxpyNTuWB9ciYnGgcYnTC6mhK6EONEw0eqZ6G_0K6QPYfVAS1jubDEXjCWut-fkaLBjxouXekZ-frn9cfOtuf_-9e7m-r5xElRpXKsFuE4L4ToYWg9CqK6HQXKph86DVQCoJDLNNZOIfhhspbxouVhC5-UZ-bT3blL8NWMuZh2yw3G0E8Y5GyEFk9ApUBX9-B_6GOc01d8Z0QvVS1l3Wimxp1yKOScczCaFtU1bw5nZhWL2oZgaivkbiulr04cX9byse_3X8ppCBeQeyPVpWmF6m_2O9g9iRJg9</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2825833347</pqid></control><display><type>article</type><title>Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy</title><source>MEDLINE</source><source>Wiley Journals</source><source>SpringerLink Journals</source><creator>Park, Jun-Gu ; Kim, Jong-Min ; Lee, Bum-Sik ; Lee, Sang-Min ; Kwon, Oh-Jin ; Bin, Seong-Il</creator><creatorcontrib>Park, Jun-Gu ; Kim, Jong-Min ; Lee, Bum-Sik ; Lee, Sang-Min ; Kwon, Oh-Jin ; Bin, Seong-Il</creatorcontrib><description>Purpose
This study aimed at determining whether overcorrection after open wedge high tibial osteotomy (OWHTO) would be predicted by the magnitude of preoperative medial and lateral coronal soft tissue laxity around the knee joint.
Methods
Overall, 68 knees of 62 patients who underwent OWHTO for primary medial osteoarthritis were retrospectively reviewed. The mechanical hip–knee–ankle (HKA) axis, weight-bearing line (WBL) ratio, medial proximal tibial angle (MPTA), joint line obliquity, coronal subluxation, and joint line convergence angle (JLCA) were measured on full-weight-bearing long-standing HKA radiographs preoperatively and at 1 year postoperatively. The varus valgus stress angle was measured on preoperative radiographs. The correction amount due to soft tissue factors was calculated as the difference between the WBL ratio on postoperative 1-year radiographs and that on virtually corrected preoperative radiographs with the same amount of MPTA at 1 year postoperatively. The patients were grouped according to the presence or absence of a ≥ 10% overcorrection of WBL ratio (overcorrection or expected correction). Multiple logistic regression analysis was performed to identify the preoperative risk factors of overcorrection.
Results
The average WBL ratio was corrected from 19.0 ± 13.5% preoperatively to 61.6 ± 9.1% postoperatively (
P
< 0.001). The average MPTA changed from 85.1 ± 1.7° preoperatively to 93.6 ± 2.6° postoperatively, resulting in an average tibia correction angle of 8.6 ± 3.1°. The average estimated correction from soft tissue factors was 5.8 ± 7.4% of the WBL ratio. Soft tissue correction of the WBL ratio > 10% was confirmed in 17 patients (28%). The preoperative JLCA and valgus stress angle were significantly greater in the overcorrection group than in the expected correction group: 5.0 ± 1.7° vs. 3.4 ± 1.9° (
P
= 0.003) and 2.4 ± 1.0° vs. 1.3 ± 1.2° (
P
= 0.002), respectively. Among the radiologic parameters, the presence of both ≥ 4° JLCA and ≥ 1.5° valgus stress angle was the only significant risk factor for overcorrection from soft tissue factors (
P
= 0.006; odds ratio, 30.2).
Conclusions
The magnitude of both medial and lateral coronal soft tissue laxity was a predictor of overcorrection from soft tissue factors after OWHTO. Overcorrection was more likely to occur in cases with both ≥ 4° JLCA and ≥ 1.5° valgus stress angle.
Level of evidence
III.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-019-05805-8</identifier><identifier>PMID: 31781797</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Ankle ; Ankle Joint - diagnostic imaging ; Ankle Joint - physiopathology ; Arthritis ; Bone surgery ; Female ; Hip Joint - diagnostic imaging ; Hip Joint - physiopathology ; Humans ; Joint Instability - physiopathology ; Joints (anatomy) ; Knee ; Knee Joint - diagnostic imaging ; Knee Joint - physiopathology ; Male ; Mathematical analysis ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Osteoarthritis ; Osteoarthritis, Knee - diagnostic imaging ; Osteoarthritis, Knee - physiopathology ; Osteoarthritis, Knee - surgery ; Osteotomy ; Osteotomy - adverse effects ; Postoperative Complications ; Preoperative Period ; Radiographs ; Radiography ; Regression analysis ; Retrospective Studies ; Risk Factors ; Soft tissues ; Stress ; Tibia ; Tibia - surgery ; Tissues ; Weight-Bearing</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020-10, Vol.28 (10), p.3164-3172</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c4927c6922c67f4d7225687f3139f6d7a577e53e091903eedffa4d7d2412b76d3</citedby><cites>FETCH-LOGICAL-c375t-c4927c6922c67f4d7225687f3139f6d7a577e53e091903eedffa4d7d2412b76d3</cites><orcidid>0000-0003-1787-1139</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-019-05805-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-019-05805-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31781797$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Jun-Gu</creatorcontrib><creatorcontrib>Kim, Jong-Min</creatorcontrib><creatorcontrib>Lee, Bum-Sik</creatorcontrib><creatorcontrib>Lee, Sang-Min</creatorcontrib><creatorcontrib>Kwon, Oh-Jin</creatorcontrib><creatorcontrib>Bin, Seong-Il</creatorcontrib><title>Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
This study aimed at determining whether overcorrection after open wedge high tibial osteotomy (OWHTO) would be predicted by the magnitude of preoperative medial and lateral coronal soft tissue laxity around the knee joint.
Methods
Overall, 68 knees of 62 patients who underwent OWHTO for primary medial osteoarthritis were retrospectively reviewed. The mechanical hip–knee–ankle (HKA) axis, weight-bearing line (WBL) ratio, medial proximal tibial angle (MPTA), joint line obliquity, coronal subluxation, and joint line convergence angle (JLCA) were measured on full-weight-bearing long-standing HKA radiographs preoperatively and at 1 year postoperatively. The varus valgus stress angle was measured on preoperative radiographs. The correction amount due to soft tissue factors was calculated as the difference between the WBL ratio on postoperative 1-year radiographs and that on virtually corrected preoperative radiographs with the same amount of MPTA at 1 year postoperatively. The patients were grouped according to the presence or absence of a ≥ 10% overcorrection of WBL ratio (overcorrection or expected correction). Multiple logistic regression analysis was performed to identify the preoperative risk factors of overcorrection.
Results
The average WBL ratio was corrected from 19.0 ± 13.5% preoperatively to 61.6 ± 9.1% postoperatively (
P
< 0.001). The average MPTA changed from 85.1 ± 1.7° preoperatively to 93.6 ± 2.6° postoperatively, resulting in an average tibia correction angle of 8.6 ± 3.1°. The average estimated correction from soft tissue factors was 5.8 ± 7.4% of the WBL ratio. Soft tissue correction of the WBL ratio > 10% was confirmed in 17 patients (28%). The preoperative JLCA and valgus stress angle were significantly greater in the overcorrection group than in the expected correction group: 5.0 ± 1.7° vs. 3.4 ± 1.9° (
P
= 0.003) and 2.4 ± 1.0° vs. 1.3 ± 1.2° (
P
= 0.002), respectively. Among the radiologic parameters, the presence of both ≥ 4° JLCA and ≥ 1.5° valgus stress angle was the only significant risk factor for overcorrection from soft tissue factors (
P
= 0.006; odds ratio, 30.2).
Conclusions
The magnitude of both medial and lateral coronal soft tissue laxity was a predictor of overcorrection from soft tissue factors after OWHTO. Overcorrection was more likely to occur in cases with both ≥ 4° JLCA and ≥ 1.5° valgus stress angle.
Level of evidence
III.</description><subject>Adult</subject><subject>Aged</subject><subject>Ankle</subject><subject>Ankle Joint - diagnostic imaging</subject><subject>Ankle Joint - physiopathology</subject><subject>Arthritis</subject><subject>Bone surgery</subject><subject>Female</subject><subject>Hip Joint - diagnostic imaging</subject><subject>Hip Joint - physiopathology</subject><subject>Humans</subject><subject>Joint Instability - physiopathology</subject><subject>Joints (anatomy)</subject><subject>Knee</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - physiopathology</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Knee - diagnostic imaging</subject><subject>Osteoarthritis, Knee - physiopathology</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Osteotomy</subject><subject>Osteotomy - adverse effects</subject><subject>Postoperative Complications</subject><subject>Preoperative Period</subject><subject>Radiographs</subject><subject>Radiography</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Soft tissues</subject><subject>Stress</subject><subject>Tibia</subject><subject>Tibia - surgery</subject><subject>Tissues</subject><subject>Weight-Bearing</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kT1PHDEQhi0EguPjD1BEltKk2eCP9c66RIgkSEhpktry2bOH0d76YnsJ9-_jy0GQUlCNZT_zjDUvIZecfeaMwVVmjHfQMK4bpnqmmv6ALHgrZQOyhUOyYLoVjWCqOyGnOT8yVo-tPiYnkkPPQcOCzHeTS2gzerpJGDeYbAlPSNfogx2pnTwdbam3Y63PoWxpyNTuWB9ciYnGgcYnTC6mhK6EONEw0eqZ6G_0K6QPYfVAS1jubDEXjCWut-fkaLBjxouXekZ-frn9cfOtuf_-9e7m-r5xElRpXKsFuE4L4ToYWg9CqK6HQXKph86DVQCoJDLNNZOIfhhspbxouVhC5-UZ-bT3blL8NWMuZh2yw3G0E8Y5GyEFk9ApUBX9-B_6GOc01d8Z0QvVS1l3Wimxp1yKOScczCaFtU1bw5nZhWL2oZgaivkbiulr04cX9byse_3X8ppCBeQeyPVpWmF6m_2O9g9iRJg9</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Park, Jun-Gu</creator><creator>Kim, Jong-Min</creator><creator>Lee, Bum-Sik</creator><creator>Lee, Sang-Min</creator><creator>Kwon, Oh-Jin</creator><creator>Bin, Seong-Il</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1787-1139</orcidid></search><sort><creationdate>20201001</creationdate><title>Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy</title><author>Park, Jun-Gu ; Kim, Jong-Min ; Lee, Bum-Sik ; Lee, Sang-Min ; Kwon, Oh-Jin ; Bin, Seong-Il</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c4927c6922c67f4d7225687f3139f6d7a577e53e091903eedffa4d7d2412b76d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Ankle</topic><topic>Ankle Joint - diagnostic imaging</topic><topic>Ankle Joint - physiopathology</topic><topic>Arthritis</topic><topic>Bone surgery</topic><topic>Female</topic><topic>Hip Joint - diagnostic imaging</topic><topic>Hip Joint - physiopathology</topic><topic>Humans</topic><topic>Joint Instability - physiopathology</topic><topic>Joints (anatomy)</topic><topic>Knee</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - physiopathology</topic><topic>Male</topic><topic>Mathematical analysis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Knee - diagnostic imaging</topic><topic>Osteoarthritis, Knee - physiopathology</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Osteotomy</topic><topic>Osteotomy - adverse effects</topic><topic>Postoperative Complications</topic><topic>Preoperative Period</topic><topic>Radiographs</topic><topic>Radiography</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Soft tissues</topic><topic>Stress</topic><topic>Tibia</topic><topic>Tibia - surgery</topic><topic>Tissues</topic><topic>Weight-Bearing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Jun-Gu</creatorcontrib><creatorcontrib>Kim, Jong-Min</creatorcontrib><creatorcontrib>Lee, Bum-Sik</creatorcontrib><creatorcontrib>Lee, Sang-Min</creatorcontrib><creatorcontrib>Kwon, Oh-Jin</creatorcontrib><creatorcontrib>Bin, Seong-Il</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Jun-Gu</au><au>Kim, Jong-Min</au><au>Lee, Bum-Sik</au><au>Lee, Sang-Min</au><au>Kwon, Oh-Jin</au><au>Bin, Seong-Il</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>28</volume><issue>10</issue><spage>3164</spage><epage>3172</epage><pages>3164-3172</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
This study aimed at determining whether overcorrection after open wedge high tibial osteotomy (OWHTO) would be predicted by the magnitude of preoperative medial and lateral coronal soft tissue laxity around the knee joint.
Methods
Overall, 68 knees of 62 patients who underwent OWHTO for primary medial osteoarthritis were retrospectively reviewed. The mechanical hip–knee–ankle (HKA) axis, weight-bearing line (WBL) ratio, medial proximal tibial angle (MPTA), joint line obliquity, coronal subluxation, and joint line convergence angle (JLCA) were measured on full-weight-bearing long-standing HKA radiographs preoperatively and at 1 year postoperatively. The varus valgus stress angle was measured on preoperative radiographs. The correction amount due to soft tissue factors was calculated as the difference between the WBL ratio on postoperative 1-year radiographs and that on virtually corrected preoperative radiographs with the same amount of MPTA at 1 year postoperatively. The patients were grouped according to the presence or absence of a ≥ 10% overcorrection of WBL ratio (overcorrection or expected correction). Multiple logistic regression analysis was performed to identify the preoperative risk factors of overcorrection.
Results
The average WBL ratio was corrected from 19.0 ± 13.5% preoperatively to 61.6 ± 9.1% postoperatively (
P
< 0.001). The average MPTA changed from 85.1 ± 1.7° preoperatively to 93.6 ± 2.6° postoperatively, resulting in an average tibia correction angle of 8.6 ± 3.1°. The average estimated correction from soft tissue factors was 5.8 ± 7.4% of the WBL ratio. Soft tissue correction of the WBL ratio > 10% was confirmed in 17 patients (28%). The preoperative JLCA and valgus stress angle were significantly greater in the overcorrection group than in the expected correction group: 5.0 ± 1.7° vs. 3.4 ± 1.9° (
P
= 0.003) and 2.4 ± 1.0° vs. 1.3 ± 1.2° (
P
= 0.002), respectively. Among the radiologic parameters, the presence of both ≥ 4° JLCA and ≥ 1.5° valgus stress angle was the only significant risk factor for overcorrection from soft tissue factors (
P
= 0.006; odds ratio, 30.2).
Conclusions
The magnitude of both medial and lateral coronal soft tissue laxity was a predictor of overcorrection from soft tissue factors after OWHTO. Overcorrection was more likely to occur in cases with both ≥ 4° JLCA and ≥ 1.5° valgus stress angle.
Level of evidence
III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31781797</pmid><doi>10.1007/s00167-019-05805-8</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1787-1139</orcidid></addata></record> |
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| source | MEDLINE; Wiley Journals; SpringerLink Journals |
| subjects | Adult Aged Ankle Ankle Joint - diagnostic imaging Ankle Joint - physiopathology Arthritis Bone surgery Female Hip Joint - diagnostic imaging Hip Joint - physiopathology Humans Joint Instability - physiopathology Joints (anatomy) Knee Knee Joint - diagnostic imaging Knee Joint - physiopathology Male Mathematical analysis Medicine Medicine & Public Health Middle Aged Orthopedics Osteoarthritis Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - physiopathology Osteoarthritis, Knee - surgery Osteotomy Osteotomy - adverse effects Postoperative Complications Preoperative Period Radiographs Radiography Regression analysis Retrospective Studies Risk Factors Soft tissues Stress Tibia Tibia - surgery Tissues Weight-Bearing |
| title | Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy |
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