Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy
Abstract Background Optimal alignment after opening-wedge high tibial osteotomy (OWHTO) is crucial for obtaining good clinical results. A hip-to-calcaneus radiograph (HCR) appears to reflect the true mechanical axis. However, no study has been reported using the HCR in patients who underwent OWHTO....
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Knee Surgery & Related Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43019-023-00203-4 |
| _version_ | 1797397899164778496 |
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| author | Hyung Jun Park Joon Hyeok Boo Dong Hun Suh Jae Gyoon Kim |
| author_facet | Hyung Jun Park Joon Hyeok Boo Dong Hun Suh Jae Gyoon Kim |
| author_sort | Hyung Jun Park |
| collection | DOAJ |
| description | Abstract Background Optimal alignment after opening-wedge high tibial osteotomy (OWHTO) is crucial for obtaining good clinical results. A hip-to-calcaneus radiograph (HCR) appears to reflect the true mechanical axis. However, no study has been reported using the HCR in patients who underwent OWHTO. We aimed to analyze the radiographic factors affecting the significant difference in the weight-bearing line (WBL) ratio between two radiographs after opening-wedge high tibial osteotomy (OWHTO). Methods This retrospective study included 51 patients who underwent both hip-to-talus radiographs (HTR) and HCR after OWHTO. The patients were divided into two groups; a consistent group (WBL ratio difference between postoperative HTR and HCR < 5%; N = 35) and an inconsistent group (> 5%; N = 16). Radiographic variables for lower extremity alignment, knee and ankle joints, and clinical scores were evaluated. The receiver operating characteristic curve was used to determine the threshold of radiographic variables that induced inconsistencies between the two radiographs. Results The mean postoperative WBL ratio in the HCR of the inconsistent group was significantly higher than that of the consistent group (57.7 ± 13.2% and 49.1 ± 11.6%, respectively) (P = 0.02). The preoperative and postoperative ankle joint line obliquity (AJLO) and preoperative lateral distal tibia ground surface angle (LDTGA) were significantly different between the two groups (P < 0.05). The preoperative AJLO (odds ratio 0.784, confidence interval 0.655–0.939, P = 0.008) significantly affected WBL ratio inconsistency. The cutoff value of the preoperative AJLO was 3.16°. However, clinical scores did not differ significantly between the two groups. Conclusion The pre-and postoperative AJLO and the preoperative LDTGA were significantly different between the two groups. Among these variables, only preoperative AJLO negatively affected the inconsistency in WBL ratios between the two radiographs (HTT and HTC). Therefore, it should be considered to prevent postoperative overcorrection of the true mechanical axis after OWHTO, even though we corrected it properly. Level of evidence Level IV. |
| first_indexed | 2024-03-09T01:17:53Z |
| format | Article |
| id | doaj.art-ba69ad10cc79424595b2db49b35d579b |
| institution | Directory Open Access Journal |
| issn | 2234-2451 |
| language | English |
| last_indexed | 2024-03-09T01:17:53Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Knee Surgery & Related Research |
| spelling | doaj.art-ba69ad10cc79424595b2db49b35d579b2023-12-10T12:22:52ZengBMCKnee Surgery & Related Research2234-24512023-12-0135111210.1186/s43019-023-00203-4Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomyHyung Jun Park0Joon Hyeok Boo1Dong Hun Suh2Jae Gyoon Kim3Department of Orthopedic Surgery, Korea University College of Medicine, Ansan HospitalDepartment of Orthopedic Surgery, Korea University College of Medicine, Ansan HospitalDepartment of Orthopedic Surgery, Korea University College of Medicine, Ansan HospitalDepartment of Orthopedic Surgery, Korea University College of Medicine, Ansan HospitalAbstract Background Optimal alignment after opening-wedge high tibial osteotomy (OWHTO) is crucial for obtaining good clinical results. A hip-to-calcaneus radiograph (HCR) appears to reflect the true mechanical axis. However, no study has been reported using the HCR in patients who underwent OWHTO. We aimed to analyze the radiographic factors affecting the significant difference in the weight-bearing line (WBL) ratio between two radiographs after opening-wedge high tibial osteotomy (OWHTO). Methods This retrospective study included 51 patients who underwent both hip-to-talus radiographs (HTR) and HCR after OWHTO. The patients were divided into two groups; a consistent group (WBL ratio difference between postoperative HTR and HCR < 5%; N = 35) and an inconsistent group (> 5%; N = 16). Radiographic variables for lower extremity alignment, knee and ankle joints, and clinical scores were evaluated. The receiver operating characteristic curve was used to determine the threshold of radiographic variables that induced inconsistencies between the two radiographs. Results The mean postoperative WBL ratio in the HCR of the inconsistent group was significantly higher than that of the consistent group (57.7 ± 13.2% and 49.1 ± 11.6%, respectively) (P = 0.02). The preoperative and postoperative ankle joint line obliquity (AJLO) and preoperative lateral distal tibia ground surface angle (LDTGA) were significantly different between the two groups (P < 0.05). The preoperative AJLO (odds ratio 0.784, confidence interval 0.655–0.939, P = 0.008) significantly affected WBL ratio inconsistency. The cutoff value of the preoperative AJLO was 3.16°. However, clinical scores did not differ significantly between the two groups. Conclusion The pre-and postoperative AJLO and the preoperative LDTGA were significantly different between the two groups. Among these variables, only preoperative AJLO negatively affected the inconsistency in WBL ratios between the two radiographs (HTT and HTC). Therefore, it should be considered to prevent postoperative overcorrection of the true mechanical axis after OWHTO, even though we corrected it properly. Level of evidence Level IV.https://doi.org/10.1186/s43019-023-00203-4KneeOpening-wedge high tibial osteotomyHip-to-talus radiographHip-to-calcaneus radiographAnkle joint line obliquity |
| spellingShingle | Hyung Jun Park Joon Hyeok Boo Dong Hun Suh Jae Gyoon Kim Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy Knee Surgery & Related Research Knee Opening-wedge high tibial osteotomy Hip-to-talus radiograph Hip-to-calcaneus radiograph Ankle joint line obliquity |
| title | Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy |
| title_full | Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy |
| title_fullStr | Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy |
| title_full_unstemmed | Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy |
| title_short | Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy |
| title_sort | analysis of radiographic factors affecting the significant differences in knee alignment between hip to talus and hip to calcaneus radiographs after opening wedge high tibial osteotomy |
| topic | Knee Opening-wedge high tibial osteotomy Hip-to-talus radiograph Hip-to-calcaneus radiograph Ankle joint line obliquity |
| url | https://doi.org/10.1186/s43019-023-00203-4 |
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