The medial proximal tibial angle accurately corrects the limb alignment in open-wedge high tibial osteotomy

AbstractMedial open wedge high tibial osteotomy (MOWHTO) is a commonly performed procedure for symptomatic medial compartment osteoarthritis (OA). However, little is known about its effects on ipsilateral ankle or hindfoot. The aim of our study was to determine the incidence of ankle or hindfoot problems after MOWHTO and examine its association with radiological indices. Thirty-five knees (32 patients) undergoing navigated MOWHTO were evaluated for the presence of new-onset ankle or hindfoot symptoms after surgery. Pre- and postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and tibial plafond inclination (TPI) were measured and compared on standing lower limb alignment radiographs. The mean postoperative change in HKA angle, MPTA, and TPI was 8.8°, 7.0°, and 8.4°, respectively. New-onset unexplained ankle or hindfoot symptoms were seen in 20% of the cases after surgery. Postoperative change in TPI was significantly greater in symptomatic patients as compared with asymptomatic ones (12.8° ± 4.9° vs. 8.1° ± 4.8°, p = 0.03). The odds ratio (OR) for developing ankle or hindfoot symptoms in cases with ≥ 10° change in TPI postoperatively was 10.8 (p = 0.04). Ankle or hindfoot symptoms were successfully managed with conservative treatment in all cases.

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Limb Alignment After Open-wedge High Tibial Osteotomy and Its Effect on the Clinical Outcome

Orthopedics ◽

10.3928/01477447-20110826-02 ◽

2011 ◽

Cited By ~ 6

Author(s):

Hosam M. El-Azab ◽

Mario Morgenstern ◽

Philip Ahrens ◽

Tibor Schuster ◽

Andreas B. Imhoff ◽

...

Keyword(s):

Clinical Outcome ◽

High Tibial Osteotomy ◽

Tibial Osteotomy ◽

Open Wedge ◽

Limb Alignment ◽

Wedge High Tibial Osteotomy

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Effect of Computer Navigation on Accuracy and Reliability of Limb Alignment Correction following Open-Wedge High Tibial Osteotomy: A Meta-Analysis

BioMed Research International ◽

10.1155/2017/3803457 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Seung-Beom Han ◽

Hyun Jung Kim ◽

Dae-Hee Lee

Keyword(s):

High Tibial Osteotomy ◽

Meta Analysis ◽

Computer Navigation ◽

Tibial Slope ◽

Tibial Osteotomy ◽

Open Wedge ◽

Limb Alignment ◽

Posterior Tibial ◽

Alignment Correction ◽

Wedge High Tibial Osteotomy

Background. It is unclear whether computer navigation can improve the accuracy and reliability of targeted lower limb alignment correction following open-wedge high tibial osteotomy (HTO). This meta-analysis was designed to compare the accuracy and reliability of limb alignment correction between computer navigated and conventional open-wedge HTOs. Methods. Studies that compared postoperative coronal alignment, including mechanical axis (MA) and weight bearing line (WBL) ratio, outliers of alignment correction, and change in tibial posterior slope, following open-wedge HTO performed using computer navigated and conventional methods were included. Results. Ten studies were included in the meta-analysis. The MA (0.93°; 95% confidence interval [CI]: 0.45–1.41°; P<0.001) and WBL ratio (1.5%; 95% CI: 0.03–2.98%; P=0.048) were significantly greater for computer navigated HTO than for conventional HTO. Outliers of alignment correction after surgery were significantly lower in patients who underwent computer navigated HTO than in those who underwent conventional HTO (odds ratio: 0.25; 95% CI: 0.08–0.79; P=0.02). Changes in posterior tibial slope from before to after surgery, however, were similar for the two approaches. Conclusion. Computer navigated HTO resulted in slightly more valgus postoperative alignment and effectively reduced outliers of alignment correction but had no effect on change in posterior tibial slope when compared with conventional HTO.

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