Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy?
Abstract Background During medial opening wedge high tibial osteotomy (MOWHTO), sometimes the plate tends to be positioned anteromedially. The plate position can affect the length of the proximal screw, which significantly affects stability after osteotomy. Therefore, research on the correlation amo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-022-06080-4 |
| _version_ | 1797958840747032576 |
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| author | Dong Jin Ryu Sang Jun Park Dae Hee Lee Kyeu-Back Kwon Geun Hong Choi Il Su Kim Joon Ho Wang |
| author_facet | Dong Jin Ryu Sang Jun Park Dae Hee Lee Kyeu-Back Kwon Geun Hong Choi Il Su Kim Joon Ho Wang |
| author_sort | Dong Jin Ryu |
| collection | DOAJ |
| description | Abstract Background During medial opening wedge high tibial osteotomy (MOWHTO), sometimes the plate tends to be positioned anteromedially. The plate position can affect the length of the proximal screw, which significantly affects stability after osteotomy. Therefore, research on the correlation among plate position, screw length, and clinical outcomes is needed. Methods This retrospective review examines 196 knees in 175 patients who underwent MOWHTO from May 2012 to December 2018, for symptomatic medial compartment osteoarthritis with a varus alignment of > 5°. We evaluated the anteroposterior plate position, length of proximal screw, and postoperative computed tomography (CT). We reviewed patients’ clinical outcome scores, presence of lateral hinge fracture, neurovascular complications, and infection. The correlation among proximal plate position, proximal screw length, and clinical outcomes was evaluated using Pearson’s correlation analysis. A subgroup analysis by screw angle (> 48 ° or < 48 °) was also performed using chi-square test and Student t-test. Results The mean proximal plate position was 16.28% (range, 5.17–44.74) of the proximal tibia’s anterior-to-posterior distance ratio, and the proximal screw length averaged 63.8 mm (range, 44–80 mm). Proximal posteromedial plate position and proximal screw length were significantly correlated (r2 = 0.667, P < .001), as were screw angle and length (r2 = 0.746, P < .001). Medial plating (< 48°) can use a longer proximal screw; nevertheless, no significant difference occurred in clinical outcomes between the two groups. Also, no differences occurred in complication rate, including hinge fracture. Conclusion With more medially positioned plating during MOWHTO, we can use longer proximal screws. However, there was no significant difference in clinical outcomes and the incidence of lateral hinge fractures regardless of plate position and screw length. |
| first_indexed | 2024-04-11T00:25:36Z |
| format | Article |
| id | doaj.art-dd7eb5c2a65b4d5b8233b72bddf13eed |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-11T00:25:36Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-dd7eb5c2a65b4d5b8233b72bddf13eed2023-01-08T12:03:08ZengBMCBMC Musculoskeletal Disorders1471-24742023-01-012411810.1186/s12891-022-06080-4Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy?Dong Jin Ryu0Sang Jun Park1Dae Hee Lee2Kyeu-Back Kwon3Geun Hong Choi4Il Su Kim5Joon Ho Wang6Department of Orthopaedic Surgery, Inha University Hospital, Inha University school of MedicineDepartment of Orthopaedic Surgery, Cheongju Micro HospitalDepartment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Orthopaedic Surgery, Samsung Bone HospitalDepartment of Orthopaedic Surgery, Samsung Maditop hospitalDepartment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background During medial opening wedge high tibial osteotomy (MOWHTO), sometimes the plate tends to be positioned anteromedially. The plate position can affect the length of the proximal screw, which significantly affects stability after osteotomy. Therefore, research on the correlation among plate position, screw length, and clinical outcomes is needed. Methods This retrospective review examines 196 knees in 175 patients who underwent MOWHTO from May 2012 to December 2018, for symptomatic medial compartment osteoarthritis with a varus alignment of > 5°. We evaluated the anteroposterior plate position, length of proximal screw, and postoperative computed tomography (CT). We reviewed patients’ clinical outcome scores, presence of lateral hinge fracture, neurovascular complications, and infection. The correlation among proximal plate position, proximal screw length, and clinical outcomes was evaluated using Pearson’s correlation analysis. A subgroup analysis by screw angle (> 48 ° or < 48 °) was also performed using chi-square test and Student t-test. Results The mean proximal plate position was 16.28% (range, 5.17–44.74) of the proximal tibia’s anterior-to-posterior distance ratio, and the proximal screw length averaged 63.8 mm (range, 44–80 mm). Proximal posteromedial plate position and proximal screw length were significantly correlated (r2 = 0.667, P < .001), as were screw angle and length (r2 = 0.746, P < .001). Medial plating (< 48°) can use a longer proximal screw; nevertheless, no significant difference occurred in clinical outcomes between the two groups. Also, no differences occurred in complication rate, including hinge fracture. Conclusion With more medially positioned plating during MOWHTO, we can use longer proximal screws. However, there was no significant difference in clinical outcomes and the incidence of lateral hinge fractures regardless of plate position and screw length.https://doi.org/10.1186/s12891-022-06080-4High tibial osteotomyPlate positionScrew lengthLateral hinge fractureClinical outcome |
| spellingShingle | Dong Jin Ryu Sang Jun Park Dae Hee Lee Kyeu-Back Kwon Geun Hong Choi Il Su Kim Joon Ho Wang Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy? BMC Musculoskeletal Disorders High tibial osteotomy Plate position Screw length Lateral hinge fracture Clinical outcome |
| title | Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy? |
| title_full | Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy? |
| title_fullStr | Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy? |
| title_full_unstemmed | Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy? |
| title_short | Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy? |
| title_sort | does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy |
| topic | High tibial osteotomy Plate position Screw length Lateral hinge fracture Clinical outcome |
| url | https://doi.org/10.1186/s12891-022-06080-4 |
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