Developing Presurgical Conversion Formulas to Predict Miniaci Angle for Personalized Realignment Targets in Opening-Wedge High Tibial Osteotomies.

IF 2.4 3区医学 Q2 ORTHOPEDICS

Orthopaedic Journal of Sports Medicine Pub Date : 2025-02-06 eCollection Date: 2025-02-01 DOI:10.1177/23259671241308916

Hongyu Chen, Liang Chen, Yuan Zhang, Qiang Wu, Mengning Yan, Xu Jiang, Liao Wang

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引用次数: 0

Abstract

Background: The correlation between the Miniaci angle and presurgical hip-knee-ankle (HKA) angle, weightbearing line (WBL) percentage, and changes in the HKA angle (ΔHKA angle) and WBL percentage (ΔWBL percentage) is significant in opening-wedge high tibial osteotomy (OWHTO). The conversion formulas that interrelate the Miniaci angle with pre-HKA angle (formula 1), pre-WBL percentage (formula 2), ΔHKA angle (formula 3), and ΔWBL percentage (formula 4) have been derived through the linear regression analysis. However, the accuracy of conversion formulas has not been validated.

Purpose: To validate the precision of conversion formulas targeting various surgical objectives for OWHTO planning in the varus knee patient population.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: A retrospective study of 155 lower limbs of 112 patients with medial unicompartmental knee osteoarthritis was conducted. A computer simulation of OWHTO was performed to calculate the Miniaci angle by delivering the WBL to the Fujisawa point (group 1), at 65% WBL percentage (group 2), and 4.5° of valgus (group 3). Spearman correlation and Bland-Altman analyses were conducted between the computer simulation and formula calculation.

Results: Upon evaluating the widely accepted Fujisawa point as a postoperative target, all formula results demonstrated a strong correlation with computer simulation outcomes (r = 0.962-0.999). Compared with the simulated Miniaci angle, the mean bias of the calculated angles derived from formulas 1 to 4 was 0.098° (formula 1), -0.268° (formula 2), 0.065° (formula 3), and -0.246° (formula 4). Notably, the formula based on the ΔHKA angle exhibited an ideal correlation with the simulated Miniaci angle (r = 0.998-0.999). In the 3 groups with varying postoperative targets, the mean bias of this formula in predicting the Miniaci angle was 0.065° (group 1), 0.070° (group 2), and 0.080° (group 3).

Conclusion: Formulas based on the presurgical HKA angle and WBL percentage showed perfect accuracy for measuring the Miniaci angle targeting the Fujisawa point. The formula based on ΔHKA angle achieved the best accuracy and may be a valuable tool for measuring the Miniaci angle in broader surgical targets.

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胫骨高位开楔截骨个体化调整靶点的术前转换公式的建立。

背景：在开楔形高位胫骨截骨术（OWHTO）中，Miniaci角与术前髋关节-膝关节-踝关节（HKA）角、负重线（WBL）百分比以及HKA角（ΔHKA角度）和WBL百分比（ΔWBL百分比）的变化具有显著的相关性。通过线性回归分析，推导出Miniaci角与pre-HKA角（公式1）、pre-WBL百分比（公式2）、ΔHKA角（公式3）、ΔWBL百分比（公式4）之间的换算公式。然而，换算公式的准确性尚未得到验证。目的：验证针对不同手术目标的转换公式在膝内翻患者群体中OWHTO计划的准确性。研究设计：横断面研究；证据水平，3。方法：对112例内侧单室膝骨关节炎患者155例下肢进行回顾性研究。计算机模拟OWHTO计算Miniaci角，将WBL放置于Fujisawa点（1组），WBL比例为65%（2组），外翻为4.5°（3组）。计算机模拟与公式计算之间进行Spearman相关和Bland-Altman分析。结果：在评价被广泛接受的Fujisawa点作为术后靶点时，所有公式结果均与计算机模拟结果具有较强的相关性（r = 0.962-0.999）。与模拟Miniaci角相比，公式1 ~公式4的计算角的平均偏差分别为0.098°（公式1）、-0.268°（公式2）、0.065°（公式3）和-0.246°（公式4）。值得注意的是，基于ΔHKA角的公式与模拟Miniaci角具有理想的相关性（r = 0.998 ~ 0.999）。在术后不同靶点的3组中，该公式预测Miniaci角的平均偏差分别为0.065°（1组）、0.070°（2组）和0.080°（3组）。结论：基于术前HKA角和WBL百分比的公式测量针对Fujisawa点的Miniaci角具有较好的准确性。基于ΔHKA角度的公式获得了最好的精度，可能是测量更广泛手术目标的Miniaci角的有价值的工具。

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

Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

7.70%

发文量

876

审稿时长

12 weeks

期刊介绍： The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).