Effect of weight-bearing on the alignment after open wedge high tibial osteotomy

2010 ◽  
Vol 18 (7) ◽  
pp. 874-878 ◽  
Author(s):  
Jae Ang Sim ◽  
Ji Hoon Kwak ◽  
Sang Hoon Yang ◽  
Eun Seok Choi ◽  
Beom Koo Lee
Keyword(s):  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

scholarly journals Early full weight bearing is safe in open-wedge high tibial osteotomy

2010 ◽  
Vol 81 (2) ◽  
pp. 193-198 ◽  
Author(s):  
Justus-Martijn Brinkman ◽  
Joan WH Luites ◽  
Ate B Wymenga ◽  
Ronald J van Heerwaarden
Keyword(s):  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

Distribution of the Force in the Knee Joint during Daily Activities after Open Wedge High Tibial Osteotomy: A Rationale for the Proper Postoperative Management

2019 ◽  
Vol 33 (02) ◽  
pp. 158-166
Author(s):  
Hansol Seo ◽  
Dohyung Lim ◽  
Young Woong Jang ◽  
Kwan-su Kang ◽  
Myung Chul Lee ◽  
...  
Keyword(s):  
Knee Joint ◽  
High Tibial Osteotomy ◽  
Knee Flexion ◽  
Weight Bearing ◽  
Daily Activities ◽  
Force Distribution ◽  
Tibial Osteotomy ◽  
Edge Region ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

AbstractThe present study was conducted to evaluate the force distribution in knee joint during daily activities after open-wedge high tibial osteotomy (OWHTO). A three-dimensional proximal tibial finite element model (FEM) was created using Mimics software to evaluate computed tomography (CT) scans of the tibia after OWHTO. The anterior and posterior gaps were 7.0 and 12.1 mm, respectively, and the target opening angle was 12 degrees. The loading ratio of the medial and lateral tibial plateaus was 6:4. To evaluate force distribution in the knee joint during activities of daily living (ADLs) after OWHTO, peak von Mises stresses (PVMSs) were analyzed at the plate and posterolateral edge region of osteotomized tibia. ADLs associated with greater knee flexion (sitting 90 degrees, standing 90 degrees, bending 90 degrees, stepping up stairs 60 degrees, and stepping downstairs 30 and 60 degrees) yielded PVMSs ranging from 195.2 to 221.5 MPa at the posterolateral edge region. In particular, stepping downstairs with knee flexion to 60 degrees produced the highest PVMS (221.5 MPa), greater than the yield strength (100–200 MPa). The highest plate PVMS was greater than 300 MPa during ADLs associated with flexion angles of approximately 90 degrees. However, these values did not exceed the yield stress (760.0 MPa). Conclusively, higher force was generated during higher flexion associated with weight-bearing and stepping downstairs produced a high force (even at lower flexion) on the posterolateral area of the tibial plateau. Therefore, a caution should be exercised when engaging in knee flexion of approximately 90 degrees and stepping downstairs in the early postoperative period when patients follow a weight-bearing rehabilitation protocol. However, this study is based on modeling; further translational studies are needed prior to clinical application.

scholarly journals The actual knee function was not influenced by joint line obliquity after open-wedge high tibial osteotomy

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 4 ◽  
Author(s):  
Mitsuaki Kubota ◽  
Youngji Kim ◽  
Taisuke Sato ◽  
Junichiro Yamaguchi ◽  
Ryuichi Ohno ◽  
...  
Keyword(s):  
Muscle Strength ◽  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Joint Line ◽  
Knee Function ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Radiological Parameters ◽  
Joint Line Obliquity ◽  
Wedge High Tibial Osteotomy

Purpose: Excessive joint line obliquity (JLO) after open-wedge high tibial osteotomy (OWHTO) induces detrimental stress on the articular cartilage. The purpose of this article is to assess the correlation between JLO and the clinical results after OWHTO. Methods: 68 patients were followed up for more than 1 year. JLO was assessed using a long-leg standing anteroposterior radiograph. The knee osteoarthritis outcome score (KOOS) and KSS (Knee Society score) objective knee score were assessed as clinical scores. The Weight-bearing line ratio (WBLR), medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), and joint line convergence angle (JLCA) were assessed as radiological parameters. The timed up-and-go (TUG) test and single-leg standing (SLS) test were performed, and the isometric muscle strength of the quadriceps and hamstrings was assessed to evaluate the knee function. The primary outcomes were the correlations between the JLO and the clinical score, radiological parameters and knee function after OWHTO. The secondary objective of this study was to detect the factor with the greatest influence on JLO. Results: There were significant correlations between the postoperative JLO and the KOOS in the subcategories of pain, activities of daily living (ADL), and sports and recreation (r = −0.311, −0.302, −0.282, p = 0.011, 0.014, 0.022, respectively). However, the postoperative JLO was not significantly correlated with the KSS, knee function, or muscle strength. The preoperative LDFA and postoperative MPTA were factors influencing increased JLO after OWHTO. Discussion: There was no significant correlation between the JLO and the actual knee function. The preoperative LDFA and postoperative MPTA were factors that influenced the increase in JLO after OWHTO.

Comparison of the Radiologic, Arthroscopic, and Clinical Outcomes between Repaired versus Unrepaired Medial Meniscus Posterior Horn Root Tear During Open Wedge High Tibial Osteotomy

2019 ◽  
Vol 34 (01) ◽  
pp. 057-066 ◽  
Author(s):  
O-Sung Lee ◽  
Seung Hoon Lee ◽  
Yong Seuk Lee
Keyword(s):  
Clinical Outcomes ◽  
High Tibial Osteotomy ◽  
Medial Meniscus ◽  
Weight Bearing ◽  
Joint Space ◽  
Posterior Horn ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Root Tear ◽  
Wedge High Tibial Osteotomy

AbstractThe efficacy and outcomes for the concurrent repair of medial meniscus posterior horn root tear (MMPHRT) during open wedge high tibial osteotomy (OWHTO) are unclear. This study compared the radiologic, arthroscopic, and clinical outcomes between repaired and unrepaired MMPHRT during OWHTO. Fifty-seven patients were prospectively enrolled from 2014 to 2016. The radiologic, arthroscopic, and clinical outcomes were compared between 25 patients who underwent OWHTO with all-inside repair of MMPRT using FasT-Fix (repaired group) and 32 patients who underwent OWHTO without repair of MMPRT (unrepaired group) with a mean 2-year follow up in both groups. The meniscal healing status was classified as complete, partial, or no healing, according to second-look arthroscopic findings. The medial meniscal extrusion (MME) was evaluated using magnetic resonance imaging. The width of medial joint space, joint line convergence angle (JLCA), posterior tibial slope (PTS), Kellgren–Lawrence (KL) grade, hip-knee-ankle angle, and weight-bearing line ratio was evaluated on simple standing. The clinical outcomes were evaluated using the Knee Society score and the Western Ontario and McMaster University score. Healing rates (partial and complete) of the MMPHRT showed a statistical difference between the two groups (repaired group vs. unrepaired group, 19/25 (76%) vs. 13/32 (40.6%), p = 0.008). The postoperative MME showed no statistical differences between groups (repaired versus unrepaired group: 4.5 ± 1.3 mm vs. 4.5 ± 2.1 mm, p = 0.909). The postoperative width of medial joint space, JLCA, PTS, and KL grade all showed no statistical differences between groups after 2 years of OWHTO. Other radiologic parameters and clinical outcomes showed no statistical differences between groups. Repair of the MMPHRT during OWHTO showed a superior healing rate to the unrepaired MMPHRT. However, repair of the MMPHRT was not related to the radiologic and clinical outcomes. Therefore, there is no clear evidence of the need for the MMPHRT repair during OWHTO.

scholarly journals Outcome after treatment of osteoarthritis with open-wedge high-tibial osteotomy with a plate: 2-year results of a Japanese cohort study

2019 ◽  
Vol 28 (1) ◽  
pp. 230949901988799
Author(s):  
Takeshi Sawaguchi ◽  
Ryohei Takeuchi ◽  
Ryuichi Nakamura ◽  
Akihiko Yonekura ◽  
Takenori Akiyama ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Oxford Knee Score ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Conservative Group ◽  
Patient Reported ◽  
Wedge High Tibial Osteotomy

Purpose: This prospective multicenter study evaluated patient reported outcomes (PROs) in individuals undergoing medial open-wedge high-tibial osteotomy (OWHTO) with plate stabilization compared to conservative care or no treatment. Methods: One hundred eighteen of 148 patients older than 40 years were elected for OWHTO with plate treatment. Thirty patients declined surgery and were followed as a conservative group. The primary outcome measure was the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 2 years. Secondary measures included Oxford knee score, Western Ontario and McMaster Universities osteoarthritis index, range of motion (ROM), joint space width (JSW), femorotibial angle (FTA), and weight-bearing line ratio (WBLR). Results: Patient enrollment and baseline characteristics were heterogeneously distributed and led to group characteristics that were not comparable. Therefore, the comparison of the KOOS between the groups showing no differences must be treated with caution. In the OWHTO plate group, all PROs and the ROM significantly improved between baseline and 2-year follow-up. JSW remained stable in the OWHTO group. The FTA and WBLR significantly changed from a mean of 179.3 (95% confidence interval (CI): 178.7, 179.9) to 169.8 (95% CI: 169.2, 170.5) and from 23.1 (95% CI: 20.7, 25.5) to 62.4 (95% CI 59.0, 65.8), respectively. Treatment failure with conversion to total knee arthroplasty occurred in 1% of the OWHTO group; and in the conservative group, 10% converted to HTO or knee arthroplasty. Conclusions: OWHTO with plate leads to significant improvement of PROs and function 2 years after intervention and demonstrates reliable mechanical axis correction with subsequent shift of weight-bearing.

Serial Assessment of Weight-Bearing Lower Extremity Alignment Radiographs After Open-Wedge High Tibial Osteotomy

2014 ◽  
Vol 30 (3) ◽  
pp. 319-325 ◽  
Author(s):  
Yong Seuk Lee ◽  
Beom Koo Lee ◽  
Jae Ho Kwon ◽  
Jong In Kim ◽  
Francis Joseph V. Reyes ◽  
...  
Keyword(s):  
Lower Extremity ◽  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Lower Extremity Alignment ◽  
Wedge High Tibial Osteotomy
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