Journal of Joint Surgery and Research最新文献

{"title":"Prevention of surgical site infection: need to focus on the enemy within","authors":"Arian Ocean Abedi ,&nbsp;Armita Armina Abedi ,&nbsp;Javad Parvizi","doi":"10.1016/j.jjoisr.2025.02.003","DOIUrl":"10.1016/j.jjoisr.2025.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>This review aimed to summarize effective measures to prevent surgical site infections (SSIs) and periprosthetic joint infections (PJIs) following total joint arthroplasty (TJA), focusing specifically on the role of the patient's microbiome in the pathogenesis of SSI and highlighting the importance of targeted decolonization strategies.</div></div><div><h3>Methods</h3><div>The impact of the microbiome of the skin, nose, and oral cavity on SSIs is examined. The review includes a detailed analysis of recent literature regarding microbiome-focused interventions and the role of synbiotics in enhancing the gastrointestinal epithelial barrier and reducing pathogen translocation. It also addresses how the host's resistome contributes to antibiotic resistance, which complicates infection prophylaxis.</div></div><div><h3>Results</h3><div>The findings suggest that strategic targeting of the microbiome through specific preoperative, intraoperative, and postoperative protocols can significantly improve surgical outcomes. The evidence supports the efficacy of microbiome-centered approaches in infection prevention, with a substantial focus on the roles of the skin, nasal, and oral microbiomes. However, the potential role of the gut microbiome remains less explored in arthroplasty.</div></div><div><h3>Conclusions</h3><div>Understanding the endogenous sources of SSIs through the microbiome offers a promising direction for reducing infection rates in TJA. While current evidence encourages a shift in pre-operative preparations and post-operative care to incorporate microbiome-centered strategies, further research is necessary to fully explore the potential of the gut microbiome in enhancing prophylaxis against SSIs and PJIs.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 73-77"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic strategies for periprosthetic femoral fractures based on three classification systems","authors":"Tomonori Baba ,&nbsp;Taiji Watari ,&nbsp;Yasuhiro Homma ,&nbsp;Kazuo Kaneko ,&nbsp;Muneaki Ishijima","doi":"10.1016/j.jjoisr.2025.02.002","DOIUrl":"10.1016/j.jjoisr.2025.02.002","url":null,"abstract":"<div><h3>Purpose</h3><div>The standardization of treatment strategies for periprosthetic femoral fractures is a critical objective for orthopedic surgeons. This review outlines detailed therapeutic approaches based on three classification systems: the Baba, AO/OTA, and Vancouver classifications.</div></div><div><h3>Methods</h3><div>This review examined implant stability assessment, internal fixation techniques, and revision strategies for hip function restoration in periprosthetic femoral fractures.</div></div><div><h3>Results</h3><div>The Baba classification objectively determines implant stability, guiding treatment selection. The AO/OTA classification assists in identifying the most appropriate internal fixation technique. The Vancouver classification informs the choice of reconstruction methods for revision surgery.</div></div><div><h3>Conclusions</h3><div>Management of periprosthetic femoral fractures necessitates specialized expertise in joint reconstruction while adhering to the fundamental principles of osteosynthesis to promote bony union.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 65-72"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of cup placement accuracy using the navigation in total hip arthroplasty between three models using inverse probability of treatment weighting","authors":"Shotaro Tachibana,&nbsp;Shinya Hayashi,&nbsp;Yuichi Kuroda,&nbsp;Tomoyuki Kamenaga,&nbsp;Masanori Tsubosaka,&nbsp;Kensuke Wada,&nbsp;Yoshihito Suda,&nbsp;Yuma Onoi,&nbsp;Kemmei Ikuta,&nbsp;Kensuke Anjiki,&nbsp;Naoki Nakano,&nbsp;Tomoyuki Matsumoto,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.jjoisr.2025.01.003","DOIUrl":"10.1016/j.jjoisr.2025.01.003","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared the accuracy of acetabular cup placement between three portable navigation systems during total hip arthroplasty (THA). Furthermore, factors affecting accuracy were investigated.</div></div><div><h3>Methods</h3><div>A total of 101 patients who underwent THA using accelerometer-based navigation, 3D mini-optical navigation, or augmented reality (AR)-based navigation were analyzed. Post-operative cup placement angles were measured using three-dimensional templates. Propensity scores were calculated based on age, sex, body mass index (BMI), and target placement angle. After adjusting for confounding factors using inverse probability of treatment weighting matching, absolute differences in post-operative and intra-operative inclination and anteversion angles were analyzed using one-way analysis of variance (<em>p</em> ​&lt; ​0.05). The backgrounds of outliers (an absolute difference in inclination or anteversion &gt;5°) and non-outliers were compared using <em>t</em>-test and Fisher's exact test. Additionally, logistic regression analysis was performed to calculate the odds ratios of background outliers.</div></div><div><h3>Results</h3><div>The absolute differences in post-operative and intra-operative inclination angles were 2.8°, 3.0°, and 2.9° for accelerometer-based navigation, 3D mini-optical navigation, and AR-based navigation, respectively, with no significant differences. The mean differences in anteversion angles among the groups were 2.2° for accelerometer-based navigation, 2.7° for 3D mini-optical navigation, and 2.2° for AR-based navigation, with no significant differences. BMI was significantly higher in the outlier group (<em>p</em> ​= ​0.03), and logistic regression analysis results showed an odds ratio of 1.2 (<em>p</em> ​= ​0.02).</div></div><div><h3>Conclusions</h3><div>This study demonstrated no significant differences in cup placement accuracy among the three navigation systems after adjusting for confounding factors. High BMI may have affected accuracy.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 59-64"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of intra-operative blood loss on the first side to perform simultaneous bilateral total hip arthroplasty without allogeneic blood transfusion","authors":"Hiroshige Hamada,&nbsp;Kazuhiro Oinuma,&nbsp;Hidetaka Higashi,&nbsp;Yoko Miura,&nbsp;Taishi Ninomiya,&nbsp;Keishin Ueno,&nbsp;Takamitsu Sato,&nbsp;Hideaki Shiratsuchi","doi":"10.1016/j.jjoisr.2025.02.001","DOIUrl":"10.1016/j.jjoisr.2025.02.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Simultaneous bilateral total hip arthroplasty (THA) offers benefits such as early rehabilitation and reduced medical costs but carries a risk of peri-operative bleeding necessitating post-operative blood transfusion. This study aimed to investigate factors associated with post-operative anemia in simultaneous bilateral THA using the direct anterior approach (DAA) and to identify criteria for limiting the surgery to one side.</div></div><div><h3>Methods</h3><div>Patients who underwent simultaneous bilateral THA without allogeneic blood transfusion during surgery at Funabashi Orthopaedic Hospital (Chiba, Japan) between January 2022 and December 2022 were included. Multiple regression analysis was performed to identify factors associated with post-operative anemia. Receiver operating characteristic (ROC) analysis was performed using the results in multiple regression analysis to calculate cutoff values.</div></div><div><h3>Results</h3><div>In total, 161 patients (28 men and 133 women) were included, with a mean age of 61 years. Pre-operative hemoglobin levels and intra-operative blood loss on the first side were identified as factors associated with post-operative anemia. ROC analysis showed that the cutoff value of intra-operative blood loss on the first side was 9.2% of the patient blood volume (PBV) when the pre-operative hemoglobin level was &lt;12 ​g/dL and 16.9% of the PBV when it was ≥12 ​g/dL.</div></div><div><h3>Conclusion</h3><div>This study identified factors associated with post-operative anemia in simultaneous bilateral THA using DAA as well as the criteria for limiting surgery to the first side to prevent post-operative blood transfusion.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 53-58"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological evaluation of coronal femoral and tibial morphology and coronal limb alignment in windswept deformity of the knee","authors":"Tomoki Koyama ,&nbsp;Takehiko Sugita ,&nbsp;Akira Sasaki ,&nbsp;Kento Harada ,&nbsp;Hidetatsu Tanaka ,&nbsp;Takashi Aki ,&nbsp;Naohisa Miyatake ,&nbsp;Seiya Miyamoto ,&nbsp;Ikuo Maeda ,&nbsp;Masayuki Kamimura ,&nbsp;Toshimi Aizawa","doi":"10.1016/j.jjoisr.2025.01.001","DOIUrl":"10.1016/j.jjoisr.2025.01.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Windswept deformity (WSD) of the knee, involving valgus deformity in one knee and varus deformity in the other, is uncommon and not well understood. This study aimed to clarify the radiological characteristics of WSD patients with osteoarthritis.</div></div><div><h3>Methods</h3><div>WSD knees with Kellgren–Lawrence stage 3 or 4 osteoarthritis in 36 patients were radiologically evaluated. Mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), arithmetic hip–knee–ankle (aHKA) angle, and joint line obliquity were measured. Comparisons in radiological measurements were made with 47 patients with bilateral valgus and 135 patients with bilateral varus knee osteoarthritis (control groups).</div></div><div><h3>Results</h3><div>Among WSD patients, 75% had valgus deformity in the right knee, while 25% had it in the left knee. The mLDFA in valgus WSD knees was significantly lower than that in varus WSD knees (85.1 ​± ​2.2° <em>vs.</em> 87.3 ​± ​2.3°; <em>p</em> &lt; ​0.001), whereas the MPTA in varus WSD knees was significantly lower than that in valgus WSD knees (83.9 ​± ​0.5° <em>vs.</em> 87.8 ​± ​0.5°; <em>p</em> ​&lt; ​0.001). The calculated aHKA angle indicated that valgus and varus WSD knees corresponded to constitutional valgus and varus alignments, respectively. Compared with the control groups, the mLDFA in valgus WSD knees was significantly higher than that in bilateral valgus knees (85.1 ​± ​0.4° <em>vs.</em> 83.5 ​± ​0.3°; <em>p</em> ​= ​0.003), whereas the mLDFA in varus WSD knees was significantly lower than that in bilateral varus knees (87.4 ​± ​0.4° <em>vs.</em> 88.5 ​± ​0.2°; <em>p</em> ​= ​0.008).</div></div><div><h3>Conclusion</h3><div>WSD is more frequently associated with right knee valgus deformity in the Japanese population. Significant side-specific differences in coronal femoral and tibial morphology and constitutional limb alignment were observed in WSD.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 48-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral extra-articular procedures in anterior cruciate ligament reconstruction: Narrative review on current evidence","authors":"Takeo Tokura ,&nbsp;Alan M.J. Getgood","doi":"10.1016/j.jjoisr.2024.12.001","DOIUrl":"10.1016/j.jjoisr.2024.12.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Techniques for anterior cruciate ligament reconstruction (ACLR) have evolved over time, but residual anterolateral rotatory instability (ALRI) often persists, which can result in poor patient-reported outcomes and an increased rate of graft failure. The re-emergence of lateral extra-articular procedures (LEAPs), either lateral extra-articular tenodesis (LET) or the newer anterolateral ligament reconstruction, in combination with ACLR has changed practice significantly. Here we describe a literature review of ACLR and LEAPs, focusing on LET.</div></div><div><h3>Methods</h3><div>Studies describing anatomy, history, biomechanical and clinical studies, and current practice regarding ACLR and LET were searched in PubMed. Our current practice and future directions are also discussed.</div></div><div><h3>Results</h3><div>There is accumulating evidence supporting the effectiveness of LEAP in controlling ALRI and reducing the risk of anterior cruciate ligament (ACL) graft failure. A number of cadaveric studies have shown that LEAP would help control ALRI in combination with ACLR. There are also several randomized controlled studies showing that addition of LET significantly reduces the risk of ACL graft failure. However, only a paucity of data about its long-term outcomes are currently available.</div></div><div><h3>Conclusions</h3><div>LEAP has had a great impact on our daily practice. However, indications, optimal ACL graft type, and long-term outcomes still need to be thoroughly investigated.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 42-47"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive symptoms associated with the development of radiographic knee osteoarthritis: a 10-year longitudinal study from the Iwaki cohort","authors":"Eitaro Sato ,&nbsp;Eiji Sasaki ,&nbsp;Daisuke Chiba ,&nbsp;Takahiro Tsushima ,&nbsp;Yuka Kimura ,&nbsp;Yukiko Sakamoto ,&nbsp;Yoshiko Takahashi ,&nbsp;Mizuri Ishida ,&nbsp;Eiichi Tsuda ,&nbsp;Yasuyuki Ishibashi","doi":"10.1016/j.jjoisr.2024.12.002","DOIUrl":"10.1016/j.jjoisr.2024.12.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This 10-year longitudinal cohort study aimed to investigate the annual rate of development of radiographic knee osteoarthritis (drKOA) and its predictive symptoms in the general Japanese population.</div></div><div><h3>Methods</h3><div>A total of 263 volunteers (154 women) from the Iwaki Health Promotion Project were followed up over 10 years. Standing anteroposterior knee radiographs were obtained and the Kellgren–Lawrence grade was evaluated. drKOA was defined as a change from grade 0 or 1 to ≥2 over 10 years. Knee symptoms were evaluated using the Knee injury and Osteoarthritis Outcome Score at baseline. Logistic regression analyses were performed to identify symptoms related to drKOA, and a predictive formula was created based on the associated symptoms.</div></div><div><h3>Results</h3><div>The overall incidence of drKOA was 52.9% (annual rate, 4.34%). Regression analysis revealed that predictive symptoms for drKOA were stiffness [<em>p</em> ​= ​0.033; odds ratio (OR) ​= ​1.89], frequent pain (<em>p</em> ​= ​0.024; OR ​= ​1.38), difficulty in ascending stairs, jumping, twisting, and kneeling (<em>p</em> ​= ​0.009–0.046; OR ​= ​1.71–2.78), and poor knee-related quality of life (<em>p</em> ​&lt; ​0.001–0.005; OR ​= ​1.53–2.18). Furthermore, the prediction formula created using these predictive symptoms demonstrated an area under the curve of 0.663, a cutoff value of 97 out of 100 points, an OR of 2.99, <em>p</em> ​&lt; ​0.001, sensitivity of 0.676, and specificity of 0.589.</div></div><div><h3>Conclusions</h3><div>The annual incidence rate of drKOA was 4.34% in the general Japanese population. The identified symptoms would be useful to predict the drKOA and consider the etiology of the early phase of this disease.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 35-41"},"PeriodicalIF":0.0,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achievement of minimal clinically important difference in shoulder function after reverse shoulder arthroplasty: a retrospective cohort study","authors":"Yumi Kubo ,&nbsp;Naoyuki Kubo ,&nbsp;Kotaro Yamakado","doi":"10.1016/j.jjoisr.2024.11.005","DOIUrl":"10.1016/j.jjoisr.2024.11.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Reverse shoulder arthroplasty (RSA) is a surgical procedure to relieve pain and improve shoulder function. This study aimed to investigate the percentage of patients achieving a minimal clinically important difference (MCID) in the American Shoulder and Elbow Surgeons (ASES) score following RSA and to examine factors associated with MCID achievement.</div></div><div><h3>Methods</h3><div>This study included 74 patients (26 males and 48 females; mean age 76.9 ​± ​4.7 years) who underwent RSA between January 2019 and July 2022. Patients were grouped based on the change in ASES total score from pre-operative to 1 year post-operative as follows: not achieved group (&lt;16 point change); and improvement criteria achieved group (≥16 point change).</div></div><div><h3>Results</h3><div>Overall, 81% of patients achieved an ASES score change of ≥16 points. There were no significant differences in demographic characteristics between the two groups. However, the not achieved group had a significantly lower pre-operative pain visual analog scale score and a significantly higher pre-operative ASES total score than the improvement criteria achieved group. Logistic regression analysis identified pre-operative ASES total score as significantly associated with MCID achievement (odds ratio ​= ​0.91, 95% confidence interval 0.87–0.96; <em>p</em> ​= ​0.0007).</div></div><div><h3>Conclusions</h3><div>The rate of patients achieving a ≥16 point improvement in the ASES total score after RSA was 81%. A high pre-operative ASES total score was identified as a factor limiting MCID achievement, suggesting that patients with a high pre-operative function may experience less significant post-operative improvement.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 31-34"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of coronal plane alignment of arthritic and healthy knees in Japan","authors":"Gai Kobayashi,&nbsp;Masahiro Hasegawa,&nbsp;Yohei Yamabe,&nbsp;Shine Tone,&nbsp;Yohei Naito,&nbsp;Akihiro Sudo","doi":"10.1016/j.jjoisr.2024.11.004","DOIUrl":"10.1016/j.jjoisr.2024.11.004","url":null,"abstract":"<div><h3>Purpose</h3><div>There are geographic differences in the prevalence of coronal plane alignment of the knee (CPAK) phenotypes. This study aimed to evaluate the CPAK classification of healthy and arthritic knees in Japan.</div></div><div><h3>Methods</h3><div>A cohort of arthritic knees (150 knees in 125 patients who underwent primary total knee arthroplasty) and a cohort of healthy knees (150 knees in 150 patients who underwent total hip arthroplasty or bipolar hip arthroplasty with healthy knees) underwent radiological assessment with long-leg radiographs and were categorized into nine phenotypes. The lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), mechanical and arithmetic hip–knee–ankle angles (mHKA and aHKA, respectively), and joint line obliquity were measured.</div></div><div><h3>Results</h3><div>The mean LDFA was 88.1° and 86.9° in the arthritic and healthy knee cohorts, respectively, and the mean MPTA was 85.2° and 86.6°, respectively. The mean mHKA was −8.0° and −1.2° and the mean aHKA was −2.9° and −0.3° in the arthritic and healthy knee cohorts, respectively. There was no significant difference in the distribution of varus/valgus knee on mHKA between the arthritic and healthy knee cohorts. In the arthritic knee cohort, most were CPAK type I (97 knees, 64.7%). Healthy knees were most commonly classified as type II (71 knees, 47.3%).</div></div><div><h3>Conclusions</h3><div>The distribution of varus/valgus knee was similar in Japanese arthritic and healthy knees. However, the distribution of the CPAK classification in the arthritic and healthy knees of Japanese individuals was different.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 26-30"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-operative change in lower limb length in inverted V-shaped high tibial osteotomy with a large correction angle is larger than that with a small correction angle","authors":"Seiju Hayashi,&nbsp;Kei Kato,&nbsp;Satoshi Miyazaki,&nbsp;Kazuki Yunokawa","doi":"10.1016/j.jjoisr.2024.11.003","DOIUrl":"10.1016/j.jjoisr.2024.11.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Although inverted V-shaped high tibial osteotomy (iVHTO) is a good option for severe varus deformity requiring a valgus correction angle &gt;15°, it is still unclear whether its several clinical advantages can be applied to varus deformities requiring a valgus correction angle ≤15°. Moreover, no previous studies have revealed why the application of iVHTO was limited to a correction angle &gt;15°. This study aimed to compare post-operative anatomical changes and to determine any applicability of iVHTO for a valgus correction angle ≤15° using three-dimensional (3D) bone models.</div></div><div><h3>Methods</h3><div>Differences in post-operative anatomical alignment changes between iVHTO with &gt;15° of correction (L-iVHTO group) and iVHTO with ≤15° of correction (S-iVHTO group) were examined. A total of 37 knees (18 ​L-iVHTO and 19 ​S-iVHTO) in 27 patients were enrolled. Pre- and post-operative 3D computed tomography bone models were reconstructed using a ZedHTO system. Post-operative anatomical changes (Δ) in posterior tibial slope (PTS), medial proximal tibial angle (MPTA), knee rotation angle (KRA), tibial torsion angle (TTA), patella tilting angle (PTA), Caton–Deschamps index (CDI), tibia length (TL), and lower leg length (LLL) were compared.</div></div><div><h3>Results</h3><div>ΔLLL in the L-iVHTO group (1.8 ​± ​5.6 ​mm) was significantly larger than that in the S-iVHTO group (−1.7 ​± ​4.8 ​mm; <em>p</em> ​&lt; ​0.01). No significant differences were observed among the groups in ΔMPTA, ΔPTS at the medial and lateral tibial plateau, ΔKRA, ΔTTA, ΔPTA, ΔCDI, and ΔTL.</div></div><div><h3>Conclusions</h3><div>Since the characteristics of hemi-open-wedge HTO (OWHTO) and hemi-closed-wedge HTO (CWHTO) might be expressed in iVHTO depending on the correction angle, surgeons should be aware pre-operatively that L-iVHTO will lengthen the LLL and S-iVHTO will shorten the LLL post-operatively.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 1","pages":"Pages 21-25"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}