Sueen Sohn1, In Jun Koh2, Man Soo Kim3, Yong In4. 1. Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea. 2. Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 3. Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 4. Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. iy1000@catholic.ac.kr.
Abstract
PURPOSE: To investigate risk factors and suggest preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy (MOWHTO). METHODS: A total of 133 consecutive patients who underwent MOWHTO were retrospectively enrolled. Patients were divided into two groups based on postoperative medial proximal tibial angle (post-MPTA) of 95°: control group (n = 111, 83.5%) with post-MPTA less than 95° and excessive MPTA group (n = 22, 16.5%) with post-MPTA 95° or more. Demographics, radiographic parameters [mechanical lateral distal femoral angle (mLDFA), MPTA, posterior tibial slope, joint line obliquity (JLO), hip-knee-ankle angle, joint line convergence angle (JLCA), weight bearing line ratio, and correction angle], and clinical outcomes of patients were compared. Multiple logistic regression analysis was performed to determine risk factors for post-MPTA 95° or more. RESULTS: Multiple logistic regression analysis showed that preoperative JLO ≥ 3° [odds ratio (OR) 6.940, 95% confidence interval (CI) 2.373-20.296, p < 0.001] and preoperative JLCA ≥ 5° (OR 5.723, 95% CI 1.833-17.865, p = 0.008) were statistically significant risk factors for post-MPTA ≥ 95°. Incidences of excessive MPTA following MOWHTO in patients with none, one, and two risk factors preoperatively were 3.7%, 26.7%, and 77.8%, respectively. CONCLUSION: Preoperative JLO ≥ 3° and JLCA ≥ 5° were two significant risk factors for excessive MPTA following MOWHTO. Thus, surgeon should consider other types of osteotomy if these two risk factors are present together preoperatively in MOWHTO candidates. LEVEL OF EVIDENCE: Level III.
PURPOSE: To investigate risk factors and suggest preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy (MOWHTO). METHODS: A total of 133 consecutive patients who underwent MOWHTO were retrospectively enrolled. Patients were divided into two groups based on postoperative medial proximal tibial angle (post-MPTA) of 95°: control group (n = 111, 83.5%) with post-MPTA less than 95° and excessive MPTA group (n = 22, 16.5%) with post-MPTA 95° or more. Demographics, radiographic parameters [mechanical lateral distal femoral angle (mLDFA), MPTA, posterior tibial slope, joint line obliquity (JLO), hip-knee-ankle angle, joint line convergence angle (JLCA), weight bearing line ratio, and correction angle], and clinical outcomes of patients were compared. Multiple logistic regression analysis was performed to determine risk factors for post-MPTA 95° or more. RESULTS: Multiple logistic regression analysis showed that preoperative JLO ≥ 3° [odds ratio (OR) 6.940, 95% confidence interval (CI) 2.373-20.296, p < 0.001] and preoperative JLCA ≥ 5° (OR 5.723, 95% CI 1.833-17.865, p = 0.008) were statistically significant risk factors for post-MPTA ≥ 95°. Incidences of excessive MPTA following MOWHTO in patients with none, one, and two risk factors preoperatively were 3.7%, 26.7%, and 77.8%, respectively. CONCLUSION: Preoperative JLO ≥ 3° and JLCA ≥ 5° were two significant risk factors for excessive MPTA following MOWHTO. Thus, surgeon should consider other types of osteotomy if these two risk factors are present together preoperatively in MOWHTO candidates. LEVEL OF EVIDENCE: Level III.
Authors: L Kohn; M Sauerschnig; S Iskansar; S Lorenz; G Meidinger; A B Imhoff; S Hinterwimmer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-05-24 Impact factor: 4.342
Authors: Philipp Schuster; Martin Schulz; Philipp Mayer; Michael Schlumberger; Micha Immendoerfer; Joerg Richter Journal: Arthroscopy Date: 2015-04-07 Impact factor: 4.772