Purpose
To evaluate whether the overcorrected medial proximal tibial angle (MPTA) affects
the clinical outcomes after open-wedge high tibial osteotomy (OWHTO) and to assess
the correlation between knee joint line obliquity (KJLO) changes and the compensatory
changes in the hip and ankle joints.
Methods
Consecutive patients who underwent OWHTO from July 2006 to August 2015 were included.
Exclusion criteria were bilateral OWHTO and follow-up of <2 years. The patients were
retrospectively divided into 2 groups according to postoperative MPTA; a normal group
(MPTA <95°) and an overcorrected MPTA group (MPTA ≥95°). The groups were compared
with respect to the clinical and radiologic outcomes after OWHTO. Clinical parameters,
including Japanese Orthopedic Association (JOA) score, Oxford Knee Score (OKS), and
Knee Injury and Osteoarthritis Outcome Score (KOOS), were evaluated. Radiologic outcomes,
including the hip-knee-ankle angle (HKA), joint line convergence angle (JLCA), MPTA,
KJLO, ankle joint line obliquity (AJLO), and hip abduction angle (HAA), were evaluated
preoperatively and at the final follow-up.
Results
Ninety-four patients (normal group; n = 52, overcorrected group; n = 42) were included
in this study. After OWTHO, the mean increases in HKA and MPTA were 11.0° ± 3.2° and
10.4° ± 2.7°, respectively, whereas the change in KJLO was only 3.7° ± 2.9°. The mean
AJLO (4.3 ± 3.9 to −1.3 ± 3.3, P < .001) and HAA (3.7 ± 2.5 to −1.1 ± 2.3, P < .001) significantly decreased after OWHTO. The mean postoperative MPTA in the overcorrected
group was 96.9° ± 1.5°, whereas the mean postoperative KJLO was only 3.1° ± 2.0°.
No significant differences were noted in all clinical scores between the groups at
the final follow-up.
Conclusions
A certain degree of overcorrected MPTA (≥95°) did not affect the clinical outcomes
after OWHTO because of compensatory changes in the hip and ankle joints.
Level of Evidence
Level Ⅲ, retrospective comparative study.
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Article info
Publication history
Accepted:
April 16,
2019
Received:
October 13,
2018
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
