Change in the weight-bearing line ratio of the ankle joint and ankle joint line orientation after knee arthroplasty and high tibial osteotomy in patients with genu varum deformity

2020 ◽  
Author(s):  
Jae Gyoon Kim ◽  
Dong Hun Suh ◽  
Gi Won Choi ◽  
Bong Mo Koo ◽  
Sang-Gyun Kim
Keyword(s):  
High Tibial Osteotomy ◽  
Ankle Joint ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Joint Line ◽  
Line Orientation ◽  
Line Ratio ◽  
Tibial Osteotomy ◽  
Genu Varum

scholarly journals Development and validation of a prediction model for knee joint line orientation after high tibial osteotomy

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Jae-Young Park ◽  
Chong Bum Chang ◽  
Dong-Wan Kang ◽  
Sohee Oh ◽  
Seung-Baik Kang ◽  
...  
Keyword(s):  
Linear Regression ◽  
Knee Joint ◽  
High Tibial Osteotomy ◽  
Linear Regression Analysis ◽  
External Validation ◽  
Joint Line ◽  
Line Orientation ◽  
Tibial Osteotomy ◽  
Correction Angle ◽  
Anatomical Alignment

Abstract Background Maintenance of optimal knee joint line orientation (KJLO) is important after high tibial osteotomy (HTO). No tools, however, are currently available that could predict the value of postoperative KJLO before surgery. First, this study sought to determine the effects of various preoperative anatomical alignment parameters to postoperative KJLO. Based upon these analyses, we aimed to devise an equation that predicts the value of postoperative KJLO. Methods A total of 14 radiographic parameters were measured in preoperative and postoperative full-limb standing anteroposterior radiographs on 50 patients who underwent open-wedge HTO. The parameters were analysed using multivariable linear regression to predict KJLO after HTO. External validation of the equation was done with 20 patients who underwent HTO at another institution. Results After HTO, KJLO increased from − 0.8° to 2.9° (P < 0.001). Based on the multivariable linear regression analysis, an equation was derived that can estimate postoperative KJLO after HTO; postoperative KJLO(°) = 1.029 + 0.560 × preoperative KJLO(°) + 0.310 × preoperative tibia plateau inclination(°) + 0.463 × aimed correction angle(°). The adjusted coefficients of determination value for this equation was 0.721. The equation also showed good calibration and predictability in external validation with predicted squared correlation coefficient of 0.867. Conclusions This study analysed the effects of preoperative anatomical alignment parameters on the postoperative KJLO. An equation which predicts postoperative KJLO with preoperative anatomical alignment factors was devised and validated. This equation would help in selecting optimal patients for HTO and in selecting the optimal target correction angle in HTO.

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.

Changes in knee joint line orientation after high tibial osteotomy are the result of adaptation of the lower limb to the new alignment

The Knee ◽  
2020 ◽  
Vol 27 (3) ◽  
pp. 777-786
Author(s):  
Stijn Bartholomeeusen ◽  
Maxim Van den Bempt ◽  
Nathalie van Beek ◽  
Toon Claes ◽  
Steven Claes
Keyword(s):  
Knee Joint ◽  
High Tibial Osteotomy ◽  
Lower Limb ◽  
Joint Line ◽  
Line Orientation ◽  
Tibial Osteotomy

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.

scholarly journals Prediction of knee joint line orientation after high tibial osteotomy

2017 ◽  
Vol 9 ◽  
pp. 15-16
Author(s):  
Chong Bum Chang ◽  
Jae-Young Park ◽  
Moon Jong Chang ◽  
Chan Yoon ◽  
Jae-Hoon Shin ◽  
...  
Keyword(s):  
Knee Joint ◽  
High Tibial Osteotomy ◽  
Joint Line ◽  
Line Orientation ◽  
Tibial Osteotomy

scholarly journals Radiological, functional, and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 12
Author(s):  
Muhammad Khurram Habib ◽  
Zeeshan Ali Khan
Keyword(s):  
High Tibial Osteotomy ◽  
Case Series ◽  
Joint Line ◽  
Line Orientation ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Female Ratio ◽  
Osteoarthritic Knee ◽  
Knee Mechanics ◽  
Anatomical Outcome

Objective: To determine the radiological, functional, and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy (HTO). Design of study: Descriptive case series. Study duration and settings: The present study was a descriptive case series carried out at the Orthopedic Departments of District Head Quarter Hospital Faisalabad affiliated with Faisalabad Medical University, Faisalabad from Jan 2014 to March 2018. Methodology: This study involved 40 patients of both genders, aged between 40 and 65 years having advanced degenerative disease of knee limited to medial compartment of joint. These patients were treated by medial open wedge high tibial osteotomy (OWHTO) and outcome was evaluated after 5 years of surgery in terms of radiological knee mechanics, functional outcome scores, and arthroscopic evidence of cartilage regeneration in the medial compartment. A signed written consent was taken from every patient. Findings: There was a female predominance with a male-to-female ratio of 1:4. The mean age of the patients was 53.2 ± 6.9 years. The values of the radiographic parameters significantly changed from pre-operative condition after HTO; mechanical tibiofemoral angle [MTFA, (−8.1 ± 1.2° vs. 2.5 ± 1.2°; p-value < 0.0001)], tibial plateau inclination [TPI, (5.3 ± 1.1° vs. 3.4 ± 1.1°; p-value < 0.0001)], knee joint line orientation relative to the ground [G-KJLO, (0.3 ± 0.1° vs. 4.6 ± 1.5°; p-value < 0.0001)], and ankle joint line orientation relative to the ground [G-AJLO (8.3 ± 3.2° vs. 2.3 ± 1.7°; p-value < 0.0001)]. There was significant improvement in patient’s functional status; KOOS-ADL score (45.5 ± 7.8 vs. 73.7 ± 8.6; p-value < 0.0001), International Knee Documentation Committee (IKDC) score (42.4 ± 6.9 vs. 68.5 ± 12.7; p-value < 0.0001), International Knee Society (IKS) score (149.4 ± 11.9 vs. 179.4 ± 10.2; p-value < 0.0001), Knee Society Score [KSS, (54.2 ± 5.6 vs. 69.7 ± 12.7; p-value < 0.0001)], and Hospital for Special Surgery [HSS, (50.8 ± 3.3 vs. 64.8 ± 10.7; p-value < 0.0001)]. 42.5% patients showed excellent regeneration of femoral and 30.0% patients showed excellent regeneration of tibial cartilage in the medial compartment. Conclusion: By significantly alternating the knee biomechanics, HTO was found to unload the medial compartment leading to regeneration of the articular cartilage and significant improvement in patient’s symptoms and quality of life. It is therefore recommended in the management of patients with arthritic changes limited to medial compartment only.

Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim Mostafa El-Ganzoury ◽  
Zeiad Mohamed Zakaria ◽  
Ahmed Elsayed ◽  
Abd Ellah Elwarwary
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Medial Compartment Osteoarthritis ◽  
Total Knee

Abstract Background Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO). Objectives The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country. Patients and Methods The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019. Results About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis. Conclusion In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.

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