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Knee Surgery, Sports Traumatology, Arthroscopy

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01-01-2013 | Knee

Gait analysis of walking before and after medial opening wedge high tibial osteotomy

Authors: Martin Lind, Jodie McClelland, Joanne E. Wittwer, Timothy S. Whitehead, Julian A. Feller, Kate E. Webster

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2013

Abstract

Introduction

Medial opening wedge high tibial osteotomy (HTO) is used to treat medial compartment osteoarthritis (OA) of the knee. HTO shifts the weight-bearing line from the medial compartment into the lateral compartment. The aim of this study was to investigate the functional biomechanical consequences of this alteration in alignment.

Methods

Eleven male patients with medial compartment osteoarthritis underwent three-dimensional gait analysis during level walking before 12 months and after medial opening wedge HTO. Nine male control subjects of a similar age were also tested using the same protocol. Sagittal and coronal angles and moments in both operated and non-operated knees were compared. Pre and postoperative radiographic coronal plane alignment was also measured.

Results

Walking speed increased significantly postoperatively (P = 0.0001) and was not different from controls. Preoperatively, maximum knee flexion in stance was reduced compared to control (P = 0.02). Postoperatively, maximum knee flexion increased significantly (P = 0.005) and was the same as the controls. Similar changes were observed for the maximum knee flexion moment. The mean maximum varus angle during stance was reduced from 13.5° preoperatively to 5.4° postoperatively (P = 0.0001) compared to (6.8°) in controls. The mean maximum adduction moment also reduced from 3.9 to 2.7 (% Bw/ht, P = 0.02), compared to 3.6 in control subjects. Interestingly, the adduction moments in the non-operated knee increased postoperatively from 3.3 to 4.1 (% Bw/ht, P = 0.02). The mean radiological mechanical alignment was changed from 172 degrees preoperatively to 180 degrees postoperatively (P < 0.001).

Conclusion

HTO resulted in normalisation of several dynamic knee function parameters such as walking speed, knee flexion and external knee flexion moment. As anticipated, HTO reduced the varus angle and adduction moments of the operated knee. An increased adduction moment in the non-operated knee over the first postoperative year was found.

Level of evidence

Prospective case–control clinical laboratory study, Level III.

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Title: Gait analysis of walking before and after medial opening wedge high tibial osteotomy
Authors: Martin Lind
Jodie McClelland
Joanne E. Wittwer
Timothy S. Whitehead
Julian A. Feller
Kate E. Webster
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1496-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Gait analysis of walking before and after medial opening wedge high tibial osteotomy

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

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