Medial joint space width and convergence angle change with time after medial opening-wedge high tibial osteotomy

Tsai, Yueh-Cheng; Tseng, Tzu-Hao; Ho, Cheng-Han; Wang, Chun‐Chieh; Shih, Yin-Chuan; Wang, Jyh-Horng

doi:10.1016/j.knee.2020.10.015

Cited by 5 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 13 Kim et al 6 reported that transection of the sMCL during OWHTO did not increase valgus laxity and showed desirable clinical and radiological outcomes. Tsai et al 20 reported that the medial compartment pressure, as represented by the JLCA, continued to decrease and became stable in 3 to 6 months despite its immediate large increase postoperatively. In addition, the change in JLCA could be larger in patients with large latent valgus instability or severe varus deformity requiring a large correction, which could lead to an unexpected overcorrection in OWHTO.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Distal Medial Collateral Ligament Release During Opening-Wedge High Tibial Osteotomy

Shim

Jeong

Park

et al. 2023

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: During opening-wedge, high-tibial osteotomy (OWHTO), various methods of managing the superficial medial collateral ligament (sMCL) can be performed to obtain a sufficient medial side opening. Purpose/Hypothesis: The purpose of this study was to evaluate the outcomes of distal sMCL release during OWHTO. It was hypothesized that distal sMCL release would not cause valgus instability. Study Design: Case series; Level of evidence, 4. Methods: This retrospective study included 77 patients who underwent OWHTO between January 1, 2018, and October 31, 2019, and completed serial radiological assessments including weightbearing line ratio (WBLR), medial proximal tibial angle (MPTA), coronal translation, total tibial plateau inclination (TTPI), valgus medial joint-space width (valgus-MJSW), valgus joint-line convergence angle (valgus-JLCA), varus lateral joint-space width (varus-LJSW), and varus joint-line convergence angle (varus-JLCA) on standing whole-leg and varus-valgus stress radiographs. Subgroup analysis of pre- to postoperative changes in radiologic parameters was performed according to TTPI (group 1: <25th percentile, group 2: 25th-75th percentile, group 3: >75th percentile) and Ahlbäck osteoarthritis classification (group 1: Ahlbäck grade 1, group 2: Ahlbäck grades 2 and 3). Results: The mean time to final follow-up was 34.6 ± 6.4 months. The WBLR and coronal translation did not change significantly over the follow-up period. The valgus-MJSW at 6 months postoperatively was significantly wider than that preoperatively and at 1 year postoperatively ( P < .001). The varus-LJSW at 6 months postoperatively was significantly wider compared with preoperatively and 1 year postoperatively ( P < .001), and the varus-LJSW at 1 year postoperatively was wider than that found preoperatively. Coronal translation was significantly more reduced for patients in TTPI group 1 versus group 3 ( P = .019). There was no significant differences according to the Ahlbäck groups. All clinical outcomes improved at final follow-up compared with preoperative values ( P ≤ .002). Conclusion: The study findings indicated that sMCL release did not cause valgus instability or valgus overcorrection at 1 year postoperatively, and improved clinical outcomes were seen at the final follow-up compared with preoperative status after OWHTO with sMCL release.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes of Distal Medial Collateral Ligament Release During Opening-Wedge High Tibial Osteotomy

Shim

Jeong

Park

et al. 2023

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…JLCA represents both soft tissue laxity around the knee joint and the thickness of the remaining cartilage [29]. Previous studies have shown that changes in the JLCA before and after MOWHTO are variable and difficult to predict [25,43] and that physicians should be careful to avoid overcorrection in significantly large JLCA [25,29,36].…”

Section: Introductionmentioning

confidence: 99%

Postoperative patient‐reported outcome measures after medial open‐wedge high tibial osteotomy was improved by decreased joint line convergence angle

Kumaki,

Tensho,

Iwaasa

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeTo evaluate the relationship between pre‐ and postoperative joint line convergence angle (JLCA) changes and patient‐reported outcome measures related to medial open‐wedge high tibial osteotomy (MOWHTO).MethodsSixty‐one patients (71 knees) who underwent MOWHTO were examined. Preoperative and 2‐year postoperative radiographic parameters (hip–knee–ankle angle, weight‐bearing line ratio, medial proximal tibial angle and JLCA) were measured, and knee injury and osteoarthritis outcome scores (KOOS) were assessed. Patients were divided into two groups: group D (decreased JLCA compared with preoperative status) included 44 knees with a ΔJLCA < 0° and group I (increased JLCA and no‐change JLCA compared with preoperative status) included 27 knees with a ΔJLCA ≥ 0°. KOOS sub‐scores and the proportion of patients whose improvement exceeded the minimum clinically important difference (MCID) were compared between both groups using Student's t tests, Mann–Whitney U tests and chi‐square tests. Multiple regression analysis was performed to determine the factor that had an influential effect on the postoperative KOOS total.ResultsSignificant differences in 2‐year postoperative KOOS were observed between the two groups, including total, symptom, pain and activities of daily living scores. Group D had significantly more patients who achieved MCID for both KOOS symptoms and pain scores than group I did. Multivariate analysis indicated that JLCA change and body mass index were significantly associated with the postoperative KOOS total.ConclusionPatients with decreased JLCA had better 2‐year post‐MOWHTO KOOS and better symptom and pain improvements. Therefore, strategies that reduce JLCA are crucial to improving clinical outcomes, and efforts should be made to improve JLCA in surgical techniques.Level of EvidenceLevel Ⅳ, Case series.

show abstract

Analysis of the determinant factor of the medial joint space width after medial opening wedge high tibial osteotomy

Jeong

Shim

Park

et al. 2023

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Medial joint space width and convergence angle change with time after medial opening-wedge high tibial osteotomy

Cited by 5 publications

References 28 publications

Outcomes of Distal Medial Collateral Ligament Release During Opening-Wedge High Tibial Osteotomy

Outcomes of Distal Medial Collateral Ligament Release During Opening-Wedge High Tibial Osteotomy

Postoperative patient‐reported outcome measures after medial open‐wedge high tibial osteotomy was improved by decreased joint line convergence angle

Analysis of the determinant factor of the medial joint space width after medial opening wedge high tibial osteotomy

Contact Info

Product

Resources

About