Association between distal tibial rotation and clinical outcomes of medial open-wedge high tibial osteotomy

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-11-28 DOI:10.1016/j.knee.2024.11.009

Chang-Wan Kim, Chang-Rack Lee, Yong-Uk Kwon, Soo-Hwan Jung, Hyun-Seung Lee

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引用次数: 0

Abstract

Background

The purpose of this study was to evaluate the association between changes in knee joint geometry after medial open-wedge high tibial osteotomy (MOWHTO) and clinical outcomes.

Methods

This was a retrospective study of patients who underwent MOWHTO (101 knees) at our hospital between January 2015 and February 2022 and who were followed up for > 2 years. Radiological and functional outcomes were compared between those who were satisfied with surgery (satisfaction group) and patients who were dissatisfied with surgery (dissatisfaction group). Multiple regression analysis was performed to analyze factors affecting the radiological parameters that significantly differed between the two groups.

Results

The average follow up period was 38.0 ± 15.4 months. There were no significant differences regarding demographic characteristics and preoperative radiological parameters between the satisfaction and dissatisfaction groups. There was a significant intergroup difference with respect to postoperative distal tibial rotation and change in distal tibial rotation (13.5 ± 4.8° and 9.5 ± 4.3°, respectively; P < 0.001). The difference in tibial rotation before and after surgery was 4.3 ± 2.3° and 1.7 ± 1.8° in the dissatisfaction and satisfaction groups (P < 0.001) Multiple regression analysis showed that the correction angle affected the distal tibial rotation in MOWHTO (R² = 0.079, ß = 0.165, P = 0.038).

Conclusions

In MOWHTO, an increase in distal tibial rotation was associated with patient dissatisfaction. Because the increase in distal tibial rotation is associated with a large correction angle, excessive distal tibial rotation should be avoided when MOWHTO requires a large correction angle.

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胫骨远端旋转与胫骨内侧开楔高位截骨临床疗效的关系

本研究的目的是评估内侧开楔形胫骨高位截骨术（MOWHTO）后膝关节几何形状变化与临床结果之间的关系。方法回顾性分析2015年1月至2022年2月在我院行MOWHTO（101膝关节）手术的患者，并对其进行随访。2年。比较手术满意组（满意组）和手术不满意组（不满意组）的放射学和功能预后。采用多元回归分析两组患者放射学参数差异的影响因素。结果平均随访时间为38.0±15.4个月。满意组和不满意组在人口学特征和术前放射学参数方面无显著差异。术后胫骨远端旋转和胫骨远端旋转变化组间差异显著（分别为13.5±4.8°和9.5±4.3°）；P & lt;0.001)。不满意组和满意组术后胫骨旋转度分别为4.3±2.3°和1.7±1.8°(P <；0.001)多元回归分析显示MOWHTO矫正角度影响胫骨远端旋转（R2 = 0.079， ß = 0.165, P = 0.038）。结论在MOWHTO中，胫骨远端旋转的增加与患者的不满有关。由于胫骨远端旋转的增加与较大的矫正角度有关，当MOWHTO需要较大的矫正角度时，应避免过度的胫骨远端旋转。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.