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Preoperative Medial Tightness And Narrow Medial Joint Space Are Predictive Factors for Lower Extremity Alignment Change Toward Varus after Open Wedge High Tibial Osteotomy

Preoperative Medial Tightness And Narrow Medial Joint Space Are Predictive Factors for Lower Extremity Alignment Change Toward Varus after Open Wedge High Tibial Osteotomy

Sung-Sahn Lee, MD., PhD., KOREA, REPUBLIC OF Young Keun Lee, MD, KOREA, REPUBLIC OF Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF Eui Yub Jung, MD, KOREA, REPUBLIC OF Joon Ho Wang, MD, PhD, KOREA, REPUBLIC OF

Samsung Medical Center, Seoul, KOREA, REPUBLIC OF


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

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Anatomic Structure

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Ligaments


Summary: : Preoperative greater valgus stress joint line convergence angle and less medial joint space width were predictive factors for greater change in alignment toward varus after OWHTO


Background

Time-dependent changes in lower extremity alignment after an open wedge high tibial osteotomy (OWHTO) was poorly investigated. Moreover, few studies investigated risk factors of postoperative alignment change.

Purpose

To investigate time-dependent alignment changes and identify predictive factors for postoperative alignment change after OWHTO.

Methods

This study included patients who underwent OWHTO between March 2010 and September 2018. A total of 142 knees were enrolled with a mean follow-up of 42 months and classified as the ‘change’ group when the amount of hip-knee-ankle (HKA) angle change was more than 1°; if otherwise, then as the ‘no change’ group. HKA angle was obtained at six time points: preoperatively, at 3 months, 6 months, 1 year, 2 years, and final follow-up postoperatively. Multiple regression analysis was performed to identify the factors that were correlated with the changes in the HKA angle from 3 months to the final follow-up.

Results

Among the 142 knees, 59 (42%) were enrolled in the change group. The overall postoperative HKA angles progressed serially toward varus after OWHTO. The mean angles of the six time points were 8.5°/-3.7°/-3.6°/-3.3°/-3.1°/-2.7°, respectively. The mean HKA angles of change and no change group were 9.1°/-4.3°/-3.4°/-2.8°/-2.0°/-1.4°/ and 8.1°/-3.3°/-3.8°/-3.6°/-3.8°/-3.7°, respectively. Greater change in the HKA angle was predicted by preoperative greater valgus stress joint line convergence angles (JLCA) and less medial joint space width.

Conclusion

Forty-two percent of OWHTO showed correction loss of more than 1° at a mean follow-up of 42 months. The overall postoperative HKA angles progressed serially to varus angles after OWHTO. Preoperative greater valgus stress JLCA and less medial joint space width were predictive factors for greater change in alignment toward varus after OWHTO.


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