Intraoperative Laximetry-Based Selective Transtibial Anterior Cruciate Ligament Reconstruction Concomitant With Medial Open Wedge High Tibial Osteotomy for Treating Varus Knee Osteoarthritis With Anterior Cruciate Ligament Deficiency

Takahashi, Tsuneari; Handa, Mikiko; Kimura, Yuya; Takeshita, Katsushi

doi:10.1016/j.eats.2022.01.016

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…Next, the width of the medial horizontal osteotomy was determined accordingly. NA‐MOWHTO was performed as previously described [ 17 ]. Medial horizontal osteotomy was gradually opened to the desired correction angle [ 16 ], and the medial tibia was fixed with the TomoFix® anatomical medial high tibial plate (DepuySynthes).…”

Section: Methodsmentioning

confidence: 99%

Postoperative improvement in patient‐reported outcomes after neutral alignment medial open wedge high tibial osteotomy for medial compartment knee osteoarthritis in patients aged ≥70 years versus younger patients

Nakashima,

Takahashi,

Matsumura

et al. 2024

J. exp. orthop.

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PurposeTo compare the postoperative clinical and radiological outcomes in patients aged ≥70 years following neutral alignment medial opening‐wedge high tibial osteotomy (NA‐MOWHTO) for medial compartment knee osteoarthritis (KOA) to those observed in younger patients.MethodsThe data of patients who underwent NA‐MOWHTO for medial compartment KOA between September 2018 and June 2022 were retrospectively analysed. The patients were categorised into groups Y (<70 years) and O (≥70 years). Age, sex, Kellgren–Lawrence classification, pre‐ and postoperative mechanical axis, weight‐bearing line ratio, medial proximal tibial angle, preoperative Tegner Activity Score and pre‐ and postoperative Lysholm scores were compared between the groups.ResultsOverall, 81 patients (60 and 21 in groups Y and O, respectively) who underwent NA‐MOWHTO were included in this study. No significant differences were found in patient characteristics between the two groups, except for the preoperative Tegner Activity Score, which was significantly higher in group Y than in group O (3 [2–4] vs. 2 [2–2], respectively; p = 0.011). The two groups exhibited no significant differences in pre‐ and postoperative knee alignments. Postoperatively, Lysholm scores improved significantly in both groups without significant differences. Additionally, no correlation was found between age and pre‐ and postoperative Lysholm scores.ConclusionsThe postoperative improvement following NA‐MOWHTO for medial compartment KOA is comparable in patients aged ≥70 and younger.Level of EvidenceLevel III, Retrospective comparative study.

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Section: Methodsmentioning

confidence: 99%

Postoperative improvement in patient‐reported outcomes after neutral alignment medial open wedge high tibial osteotomy for medial compartment knee osteoarthritis in patients aged ≥70 years versus younger patients

Nakashima,

Takahashi,

Matsumura

et al. 2024

J. exp. orthop.

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“…MOWHTO with a 6 mm opening wedge was performed on all specimens according to standard surgical instructions [ 22 ]. First, a 1.6 mm K‐wire was punctured 45 mm from the medial joint line and directed towards the fibular tip.…”

Section: Methodsmentioning

confidence: 99%

Effect of plate design on maintenance of anterior and posterior gaps and posterior tibial slope after cyclic loading in medial open‐wedge high tibial osteotomy: A biomechanical study using porcine's tibia

Nibe,

Takahashi,

Matsumura

et al. 2024

J. exp. orthop.

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PurposeWe aimed to investigate whether a plate adapted to the anatomy of the proximal medial porcine's tibia would provide maintenance of the anterior gap (AG), posterior gap (PG) and posterior tibial slope (PTS).MethodsTwenty‐seven porcine tibias were biomechanically evaluated by performing MOWHTO and placing TOMOFIX (n = 9), AC plate (n = 9) and TriS (n = 9) anteromedially. Cyclic testing (800 N, 2000 cycles, 0.5 Hz) was performed to investigate the PTS over time for MOWHTO. The particular displacement calculated from the maximum to the minimum point with the load‐displacement curve along the mechanical axis during cyclic testing, the final AG and PG changes at the osteotomy site, the increased PTS calculated by subtracting AG from PG after 2000 cycles were compared among the three groups. The displacement was evaluated by repeated‐measures analysis of variance (ANOVA), and changes in AG and PG and increased PTS were evaluated by one‐way ANOVA. The sample size for α and β errors were <0.05 and <0.20, and the effect size was 0.64 for one‐way ANOVA and 0.49 for repeated‐measures ANOVA.ResultsThere were no significant differences in displacement among the groups. A significant difference was observed in the AG (p = 0.044) and PG (p = 0.0085) changes. There were no significant differences in increased PTS among the groups.ConclusionWhen anteromedially placed, the AC plate and TriS resulted in significant maintenance of AG and PG compared with that of TOMOFIX in MOWHTO after cyclic loading.Level of EvidenceLevel Ⅳ.

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“…Maximum circumference of the thigh and shank was measured in both legs. Knee stability in anterior-posterior translation (drawer test; knee flexion, 20-30°) was assessed bilaterally using the Rolimeter 39 (Aircast Europe GmbH) with manual maximum anterior force to the tibia, 50 and the ROM of both knees was measured using a goniometer. Outcomes are presented as the side-to-side difference (SSD; operated – contralateral, nondominant – dominant).…”

Section: Methodsmentioning

confidence: 99%

Favorable Patient-Reported, Clinical, and Functional Outcomes 2 Years After ACL Repair and InternalBrace Augmentation Compared With ACL Reconstruction and Healthy Controls

Müller,

Bühl,

Nüesch

et al. 2023

Am J Sports Med

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Background: Recently, interest in anterior cruciate ligament (ACL) preservation and repair after proximal ACL tears has been resurrected. Although good clinical outcomes have been reported in the literature with adequate patient selection, to date detailed scientific evidence for the functional benefit of primary ACL repair with ligament augmentation is scarce. Purpose: To compare patient-reported, clinical, and functional outcomes in patients 2 years after ACL repair and InternalBrace augmentation (ACL-IB) with age- and sex-matched patients 2 years after ACL reconstruction (ACL-R) and with matched healthy controls. Study Design: Cohort study; Level of evidence, 3. Methods: In total, 29 patients 2 years after ACL-IB, 27 sex- and age- matched patients 2 years after ACL-R (hamstring autografts), and 29 matched healthy controls were included. Patient-reported outcomes were assessed using the International Knee Documentation Committee score, Knee injury and Osteoarthritis Outcome Score, EQ-5D-5L, Tegner Activity Scale, and Anterior Cruciate Ligament Return to Sports after Injury scale. Surgery time was recorded. For clinical outcomes, range of motion and thigh and shank circumference were measured, and passive anterior translation was determined using the Rolimeter. Isokinetic muscle strength was measured using a Biodex dynamometer. The limb symmetry index (operated/contralateral or nondominant/dominant × 100), side-to-side differences (operated – contralateral, nondominant – dominant), and hamstring-quadriceps ratios were calculated for functional parameters. Failure and reoperation rates were not compared. Results: Two years after surgery, patients treated with ACL-IB showed good to excellent patient-reported outcomes comparable with those of patients after ACL-R. Surgery time, including concomitant surgeries, was significantly shorter in the ACL-IB group (mean, 81 minutes) compared with the ACL-R group (mean, 97 minutes) ( P = .024). Isokinetic muscle strength was comparable between patient groups without significant differences in extensor and flexor strength or in hamstring-quadriceps ratios. Conclusion: These results suggest that ACL-IB achieves comparable patient-reported, clinical, and functional outcomes with ACL-R at 2 years postoperatively and, after careful patient selection, should be considered as a valuable early treatment alternative for proximal ACL tears. Registration: NCT04429165 (ClinicalTrials.gov identifier).

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Intraoperative Laximetry-Based Selective Transtibial Anterior Cruciate Ligament Reconstruction Concomitant With Medial Open Wedge High Tibial Osteotomy for Treating Varus Knee Osteoarthritis With Anterior Cruciate Ligament Deficiency

Cited by 7 publications

References 19 publications

Postoperative improvement in patient‐reported outcomes after neutral alignment medial open wedge high tibial osteotomy for medial compartment knee osteoarthritis in patients aged ≥70 years versus younger patients

Postoperative improvement in patient‐reported outcomes after neutral alignment medial open wedge high tibial osteotomy for medial compartment knee osteoarthritis in patients aged ≥70 years versus younger patients

Effect of plate design on maintenance of anterior and posterior gaps and posterior tibial slope after cyclic loading in medial open‐wedge high tibial osteotomy: A biomechanical study using porcine's tibia

Favorable Patient-Reported, Clinical, and Functional Outcomes 2 Years After ACL Repair and InternalBrace Augmentation Compared With ACL Reconstruction and Healthy Controls

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