0 83

Cited 0 times in

Preoperative joint line obliquity, a newly identified factor for overcorrection, can be incorporated into a novel preoperative planning method to optimise alignment in high tibial osteotomy

Authors
 Se-Han Jung  ;  Min Jung  ;  Kwangho Chung  ;  Sungjun Kim  ;  Kyoung-Tak Kang  ;  Jisoo Park  ;  Woongseob Sim  ;  Chong-Hyuk Choi  ;  Sung-Hwan Kim 
Citation
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol.32(1) : 64-77, 2024-01 
Journal Title
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
ISSN
 0942-2056 
Issue Date
2024-01
MeSH
Humans ; Knee Joint* / diagnostic imaging ; Knee Joint* / surgery ; Osteoarthritis, Knee* / diagnostic imaging ; Osteoarthritis, Knee* / surgery ; Osteotomy / methods ; Retrospective Studies ; Tibia / diagnostic imaging ; Tibia / surgery
Keywords
high tibial osteotomy ; joint line convergence angle ; joint line obliquity ; overcorrection ; preoperative planning
Abstract
PURPOSE: The aim of this study was to analyse the factors associated with additional postoperative alignment changes after accurate bony correction by selecting only patients with well-performed bony correction as planned and develop a method of incorporating significant factors into preoperative planning. METHODS: Among 104 consecutive patients who underwent medial open wedge high tibial osteotomy (MOWHTO) between October 2019 and July 2022, 61 with well-performed bony corrections were retrospectively reviewed. The major criterion for well-performed bony correction was a difference of <1 degrees between the simulated medial proximal tibial angle (MPTA) and the actual postoperative MPTA as measured in three dimensions. Radiographic parameters, such as the joint line convergence angle (JLCA) and joint line obliquity (JLO), were measured preoperatively and postoperatively, utilising standing and supine whole lower extremity anteroposterior, valgus and varus stress radiographs. Multiple linear regression analysis identified the factors affecting alignment changes, and a prediction model was developed. A method for applying this prediction model to preoperative planning was proposed. RESULTS: Preoperative JLCA on standing (preJLCA(std) ), preoperative JLCA on 0 degrees valgus stress radiograph (vgJLCA(0) ), and preoperative JLO (preJLO) were significantly correlated with JLCA change (∆JLCA) (p < 0.001, p < 0.001, p = 0.006). The prediction model was estimated as ∆JLCA = 0.493 x (vgJLCA(0) ) - 0.727 x (preJLCA(std) ) + 0.189 x (preJLO) - 1.587 in. (R = 0.815, modified R(2) = 0.646, p < 0.001). The proposed method resulted in a reduced overcorrection rate (p = 0.003) and an improved proportion of acceptable alignments (p = 0.013). CONCLUSION: PreJLCA(std) , vgJLCA(0) and preJLO can be used to estimate ∆JLCA. PreJLO was recently identified as a significant factor associated with additional alignment changes. Utilising the proposed preoperative planning and a prediction model with these factors shows promise in calibrating postoperative alignment after MOWHTO
Full Text
https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12022
DOI
10.1002/ksa.12022
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sungjun(김성준) ORCID logo https://orcid.org/0000-0002-7876-7901
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
Chung, Kwangho(정광호) ORCID logo https://orcid.org/0000-0003-3097-3332
Jung, Min(정민) ORCID logo https://orcid.org/0000-0002-7527-4802
Jung, Se-Han(정세한) ORCID logo https://orcid.org/0000-0001-8422-093X
Choi, Chong Hyuk(최종혁) ORCID logo https://orcid.org/0000-0002-9080-4904
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198555
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links