Varus inclination of the distal femur and high tibial osteotomy

Terauchi, Masanori; Shirakura, Kenji; Katayama, Masayoshi; Higuchi, Hirofumi; Takagishi, Kenji; Kimura, M.

doi:10.1302/0301-620x.84b2.0840223

Cited by 36 publications

(40 citation statements)

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“…3C). 6 The KJLO was the angle formed by the line parallel to the ground and the line tangent to the tibial condyles (medial inclination, þ; lateral inclination, À) (►Fig. 3D).…”

Section: Measurement Of Radiographic Parametersmentioning

confidence: 99%

“…In cases of severe varus deformity of the knee joint due to proximal tibial varus deformity or combined varus deformity of both the distal femur and proximal tibia, the proximal tibia should be overcorrected to solve these problems by OWHTO, which can increase knee joint line obliquity (KJLO, lateral inclination) in the coronal plane. [4][5][6][7] In many previous studies, the authors reported that a change in knee joint alignment causes a change in ankle joint alignment. Conversely, a change in ankle joint alignment also affects knee joint alignment and biomechanics.…”

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confidence: 99%

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Analysis of Knee Joint Line Obliquity after High Tibial Osteotomy

Bae

et al. 2016

J Knee Surg

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The aim of this study was to evaluate which lower extremity alignment (knee and ankle joint) parameters affect knee joint line obliquity (KJLO) in the coronal plane after open wedge high tibial osteotomy (OWHTO). Overall, 69 knees of patients that underwent OWHTO were evaluated using radiographs obtained preoperatively and from 6 weeks to 3 months postoperatively. We measured multiple parameters of knee and ankle joint alignment (hip-knee-ankle angle [HKA], joint line height [JLH], posterior tibial slope [PS], femoral condyle-tibial plateau angle [FCTP], medial proximal tibial angle [MPTA], mechanical lateral distal femoral angle [mLDFA], KJLO, talar tilt angle [TTA], ankle joint obliquity [AJO], and the lateral distal tibial ground surface angle [LDTGA]; preoperative [-pre], postoperative [-post], and the difference between -pre and -post values [-Δ]). We categorized patients into two groups according to the KJLO-post value (the normal group [within ± 4 degrees, 56 knees] and the abnormal group [greater than ± 4 degrees, 13 knees]), and compared their -pre parameters. Multiple logistic regression analysis was used to examine the contribution of the -pre parameters to abnormal KJLO-post. The mean HKA-Δ (-9.4 ± 4.7 degrees) was larger than the mean KJLO-Δ (-2.1 ± 3.2 degrees). The knee joint alignment parameters (the HKA-pre, FCTP-pre) differed significantly between the two groups ( < 0.05). In addition, the HKA-pre (odds ratio [OR] = 1.27, = 0.006) and FCTP-pre (OR = 2.13, = 0.006) were significant predictors of abnormal KJLO-post. However, -pre ankle joint parameters (TTA, AJO, and LDTGA) did not differ significantly between the two groups and were not significantly associated with the abnormal KJLO-post. The -pre knee joint alignment and knee joint convergence angle evaluated by HKA-pre and FCTP-pre angle, respectively, were significant predictors of abnormal KJLO after OWHTO. However, -pre ankle joint parameters were not significantly associated with abnormal KJLO after OWHTO.

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“…3C). 6 The KJLO was the angle formed by the line parallel to the ground and the line tangent to the tibial condyles (medial inclination, þ; lateral inclination, À) (►Fig. 3D).…”

Section: Measurement Of Radiographic Parametersmentioning

confidence: 99%

mentioning

confidence: 99%

Analysis of Knee Joint Line Obliquity after High Tibial Osteotomy

Bae

et al. 2016

J Knee Surg

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“…The osteotomy was stabilized using a long-type locking plate (TomoFix, Synthes, Bettlach, Switzerland; or TriS, Olympus Terumo Biomaterials, Tokyo, Japan). An artificial bone graft (OSferion 60; Olympus Terumo Biomaterials) was inserted into the osteotomy gap to start early weight-bearing [14].…”

Section: Surgical Technique and Postoperative Rehabilitationmentioning

confidence: 99%

Perioperative pain control is important for prevention of venous thromboembolism after around the knee osteotomy

Kubota¹,

Kim²,

Sato³

et al. 2020

Preprint

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Background: Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE) are well-known complications after TKA. However, there are few reports about VTEs after around the knee osteotomy (AKO). Purpose: To investigate the incidence of and risk factors for VTEs after AKO. Methods: A total 108 AKO cases were assessed in this study. The procedures included open-wedge high tibial osteotomy (OWHTO; n=96), hybrid closed-wedge high tibial osteotomy (CWHTO; n=7), distal femoral osteotomy (DFO; n=2), tibial condylar valgus osteotomy (TCVO; n=2), and double level osteotomy (DLO; n=1). Ultrasonography of the lower extremities was performed for all patients at 1 week after AKO. The incidence of VTEs was investigated, and a logistic regression analysis was performed to determine which patient demographics, pre-operative clinical results and surgical factors were associated with DVT or PE after surgery. Results: Of the 108 patients who underwent AKO, 29 (26.9%) developed postoperative DVT, but no patients developed PE. The logistic regression analysis identified abrasion chondroplasty (odds ratio [OR], 3.46) and pre-operative pain visual analog scale (VAS; OR, 1.05) as independent predictors of DVT. Conclusion: The incidence of DVT after AKO is relatively high and preoperative and postoperative pain may induce DVT. Perioperative pain control is important for preventing VTEs.

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“…The osteotomy should maintain neutral joint-line obliquity and thus not increase the shear stresses at the joint surface (Babis et al, 2002). Excessive obliquity prevents the shift of weight bearing to the lateral compartment and may cause a recurrence of the varus deformity following high tibial osteotomy (Terauchi et al, 2002). (Levigne and Bonnin, 1991) differentiated congenital tibial bone varus (TBVA) from acquired tibial varus malalignment, which results from bone wear in medial gonarthrosis.…”

Section: Preoperative Planningmentioning

confidence: 99%