Masaki Tsuji1, Yasushi Akamatsu2, Hideo Kobayashi2, Naoto Mitsugi3, Yutaka Inaba2, Tomoyuki Saito2. 1. Department of Orthopaedic Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. t176042g@yokohama-cu.ac.jp. 2. Department of Orthopaedic Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. 3. Department of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57 Urahunecho, Minami-ku, Yokohama, Japan.
Abstract
INTRODUCTION: Using a navigation system in open-wedge high tibial osteotomy (OWHTO) has higher accuracy than using the conventional method. However, unintentional over- and under-correction still exist. This study aimed to compare various factors related to over- and under-correction and to assess their predictive factors in the preoperative radiographs. MATERIALS AND METHODS: This study involved 96 knees. The difference in the hip-knee-ankle angle (HKA) between the intraoperative navigation system and postoperative radiograph was termed navigation correction loss (NCL). Knees with absolute values of NCL (|NCL|) ≦ 1.5° and |NCL| > 1.5° were categorised into acceptable (n = 46) and outlier (n = 50) groups, respectively. The differences in joint line convergence angle (JLCA) between varus and valgus radiographs, varus JLCA, valgus JLCA, standing JLCA and standing HKA were compared between the two groups. Clinical results were evaluated using the American Knee Society (AKS) scores. RESULTS: The mean intraoperative HKA in the navigation system was - 3.8 ± 1.8°, and that in the postoperative standing radiograph was - 4.2 ± 2.5° (p = 0.033). Preoperative varus, valgus and standing JLCA were higher in the outlier group (p = 0.018, p = 0.020 and p = 0.001, respectively). Logistic regression analyses for preoperative factors of |NCL| ≦ 1.5° showed that standing JLCA was a determining factor, with an odds ratio of 1.334 (confidence interval was 1.087-1.637, p = 0.006). AKS score was higher in the acceptable group (p = 0.040) postoperatively. CONCLUSIONS: Higher preoperative standing JLCA was the predictive factor of |NCL| > 1.5°. This factor reduced the rates of under- and over-correction and resulted in better AKS score in OWHTO.
INTRODUCTION: Using a navigation system in open-wedge high tibial osteotomy (OWHTO) has higher accuracy than using the conventional method. However, unintentional over- and under-correction still exist. This study aimed to compare various factors related to over- and under-correction and to assess their predictive factors in the preoperative radiographs. MATERIALS AND METHODS: This study involved 96 knees. The difference in the hip-knee-ankle angle (HKA) between the intraoperative navigation system and postoperative radiograph was termed navigation correction loss (NCL). Knees with absolute values of NCL (|NCL|) ≦ 1.5° and |NCL| > 1.5° were categorised into acceptable (n = 46) and outlier (n = 50) groups, respectively. The differences in joint line convergence angle (JLCA) between varus and valgus radiographs, varus JLCA, valgus JLCA, standing JLCA and standing HKA were compared between the two groups. Clinical results were evaluated using the American Knee Society (AKS) scores. RESULTS: The mean intraoperative HKA in the navigation system was - 3.8 ± 1.8°, and that in the postoperative standing radiograph was - 4.2 ± 2.5° (p = 0.033). Preoperative varus, valgus and standing JLCA were higher in the outlier group (p = 0.018, p = 0.020 and p = 0.001, respectively). Logistic regression analyses for preoperative factors of |NCL| ≦ 1.5° showed that standing JLCA was a determining factor, with an odds ratio of 1.334 (confidence interval was 1.087-1.637, p = 0.006). AKS score was higher in the acceptable group (p = 0.040) postoperatively. CONCLUSIONS: Higher preoperative standing JLCA was the predictive factor of |NCL| > 1.5°. This factor reduced the rates of under- and over-correction and resulted in better AKS score in OWHTO.
Entities:
Keywords:
Coronal alignment; Joint line convergence angle; Navigation system; Open-wedge high tibial osteotomy
Authors: Y Akamatsu; N Mitsugi; Y Mochida; N Taki; H Kobayashi; R Takeuchi; T Saito Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-07-29 Impact factor: 4.342
Authors: R Iorio; M Pagnottelli; A Vadalà; S Giannetti; P Di Sette; P Papandrea; F Conteduca; A Ferretti Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-11-24 Impact factor: 4.342
Authors: Florian Gebhard; Christian Krettek; Tobias Hüfner; Paul A Grützner; Ulrich Stöckle; Andreas B Imhoff; Stephan Lorenz; Jan Ljungqvist; Peter Keppler Journal: Arch Orthop Trauma Surg Date: 2010-07-06 Impact factor: 3.067
Authors: P Behrendt; R Akoto; I Bartels; G Thürig; H Fahlbusch; A Korthaus; D Dalos; M Hoffmann; K-H Frosch; M Krause Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-08-22 Impact factor: 4.114