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Does Generalized Joint Laxity Affect Postoperative Alignment and Clinical Outcomes Following Medial Opening-Wedge High Tibial Osteotomy?

Does Generalized Joint Laxity Affect Postoperative Alignment and Clinical Outcomes Following Medial Opening-Wedge High Tibial Osteotomy?

Hyukjin Jang, MD, KOREA, REPUBLIC OF Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF

Seoul St. Mary hospital, Catholic university of Korea, Seoul, KOREA, REPUBLIC OF


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Summary: The GJL significantly affected postoperative overcorrection of alignment following MOWHTO. However, there was no significant difference in PRO between the patients with and without GJL after MOWHTO until 2 years.


Introduction

The purpose of this study was to investigate whether generalized joint laxity (GJL) affects the postoperative alignment and clinical outcomes of Medial opening-wedge high tibial osteotomy (MOWHTO).

Methods

A 198 patients was divided into two groups according to absence or presence of GJL. GJL was measured using the Beighton and Horan criteria, and a score of 4 or more out of 9 was defined as GJL. A weight bearing line (WBL) ratio of 55–70% was considered an acceptable postoperative lower limb alignment range. The WBL ratio was investigated before and 2 years after surgery, and the Western Ontario McMaster University Osteoarthritis Index scale score (WOMAC) was evaluated for patient-reported outcomes (PRO) of MOWHTO.

Results

There were 147 (73.7%) patients in the non-GJL group and 51 (26.3%) in the GJL group. Preoperatively, there was no difference in hip-knee-ankle (HKA) angle or WBL ratio (all p>0.05). At 2 years postoperatively, the GJL group showed significantly higher HKA angle and WBL ratio than the non-GJL group (all p<0.05). There was a significant difference in the distribution ratio of under-, normo-, and overcorrection patients between the non-GJL group (23.8%, 72.1%, and 4.1%, respectively) and GJL group (15.7 %, 70.6 %, and 13.7%, respectively) (p<0.05). There were no differences between the two groups in preoperative and postoperative WOMAC scores (all p>0.05).

Conclusion

The GJL significantly affected postoperative overcorrection of alignment following MOWHTO. However, there was no significant difference in PRO between the patients with and without GJL after MOWHTO until 2 years.


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