Risk factors and preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy

被引:17
|
作者
Sohn, Sueen [1 ]
Koh, In Jun [2 ]
Kim, Man Soo [3 ]
In, Yong [3 ]
机构
[1] Inje Univ, Sanggye Paik Hosp, Dept Orthopaed Surg, Coll Med, Seoul, South Korea
[2] Catholic Univ Korea, Eunpyeong St Marys Hosp, Dept Orthopaed Surg, Coll Med, Seoul, South Korea
[3] Catholic Univ Korea, Seoul St Marys Hosp, Dept Orthopaed Surg, Coll Med, Seoul, South Korea
关键词
Medial opening-wedge high tibial osteotomy; Coronal inclination; Excessive joint line obliquity; Risk factor; Knee osteoarthritis; DOUBLE LEVEL OSTEOTOMY; JOINT-LINE OBLIQUITY; OSTEOARTHRITIS; VARUS; COMPARTMENT; ALIGNMENT; KNEE;
D O I
10.1007/s00402-020-03660-8
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose To investigate risk factors and suggest preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy (MOWHTO). Methods A total of 133 consecutive patients who underwent MOWHTO were retrospectively enrolled. Patients were divided into two groups based on postoperative medial proximal tibial angle (post-MPTA) of 95 degrees: control group (n = 111, 83.5%) with post-MPTA less than 95 degrees and excessive MPTA group (n = 22, 16.5%) with post-MPTA 95 degrees or more. Demographics, radiographic parameters [mechanical lateral distal femoral angle (mLDFA), MPTA, posterior tibial slope, joint line obliquity (JLO), hip-knee-ankle angle, joint line convergence angle (JLCA), weight bearing line ratio, and correction angle], and clinical outcomes of patients were compared. Multiple logistic regression analysis was performed to determine risk factors for post-MPTA 95 degrees or more. Results Multiple logistic regression analysis showed that preoperative JLO >= 3 degrees [odds ratio (OR) 6.940, 95% confidence interval (CI) 2.373-20.296, p < 0.001] and preoperative JLCA >= 5 degrees (OR 5.723, 95% CI 1.833-17.865, p = 0.008) were statistically significant risk factors for post-MPTA >= 95 degrees. Incidences of excessive MPTA following MOWHTO in patients with none, one, and two risk factors preoperatively were 3.7%, 26.7%, and 77.8%, respectively. Conclusion Preoperative JLO >= 3 degrees and JLCA >= 5 degrees were two significant risk factors for excessive MPTA following MOWHTO. Thus, surgeon should consider other types of osteotomy if these two risk factors are present together preoperatively in MOWHTO candidates.
引用
收藏
页码:561 / 569
页数:9
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