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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-10-2023 | KNEE

Changes in ankle and hip joints following medial opening-wedge high tibial osteotomy affect knee joint line obliquity

Authors: Sang-Gyun Kim, June-Bum Jun, Il Wook Bae, Dae-Hee Lee

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2023

Abstract

Purpose

This study aimed to measure the change in knee joint line obliquity (KJLO) and the changes in radiologic parameters of the ankle and hip joints after medial opening-wedge high tibial osteotomy (MOWHTO), and to evaluate the correlation and causal relationship between these parameters.

Methods

This study evaluated 109 patients who underwent MOWHTO between April 2015 and December 2021. Radiologic parameters, including KJLO, medial proximal tibial angle (MPTA), ankle joint line obliquity (AJLO), and hip abduction angle (HAA), were analysed before and 1 year after MOWHTO. Multiple linear regression analysis was used to identify independent variables that significantly affected the change in KJLO after MOWHTO. Receiver operating characteristic (ROC) analysis was used to evaluate the cutoff value for a change in KJLO that exceeded 5° postoperatively, and the predicting values of radiologic parameters.

Results

Multiple linear regression analysis showed that changes in MPTA, AJLO, and HAA (β = 0.440, P < 0.001; β = − 0.310, P < 0.001; β = 0.164, P = 0.035, respectively) were predictors of the change in KJLO after MOWHTO. ROC analysis showed that the threshold value for a change in KJLO which exceeded 5° postoperatively was 4.6° (66.7% sensitivity, 63.8% specificity, P = 0.025). Moreover, ROC curves for predicting a change in KJLO of > 4.6° showed that the AUC was significantly higher for the change in MPTA than that of the other two parameters (P = 0.011 for AJLO and P < 0.001 for HAA).

Conclusion

MOWHTO increases the KJLO by valgization of the proximal tibia and causes hip adduction and ankle valgization. The postoperative ankle valgization after MOWHTO could reduce the increase in KJLO, counteracting the effects of proximal tibial valgization and hip adduction. Therefore, the effects of the hip and ankle joints should be considered to achieve an optimal KJLO and satisfactory clinical outcomes after MOWHTO.

Level of study

Cohort study, IV.

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Title: Changes in ankle and hip joints following medial opening-wedge high tibial osteotomy affect knee joint line obliquity
Authors: Sang-Gyun Kim
June-Bum Jun
Il Wook Bae
Dae-Hee Lee
Publication date: 01-10-2023
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-023-07581-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in ankle and hip joints following medial opening-wedge high tibial osteotomy affect knee joint line obliquity

Abstract

Purpose

Methods

Results

Conclusion

Level of study

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of study

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