Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning
Abstract Background To evaluate the expected postoperative total leg length change using preoperative radiographs during surgical planning of four different methods of double level osteotomy (DLO). Methods This study included 34 patients (44 knees) who underwent DLO for varus knee osteoarthritis. Su...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Knee Surgery & Related Research |
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| Online Access: | https://doi.org/10.1186/s43019-023-00198-y |
| _version_ | 1797452202664525824 |
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| author | Shuntaro Nejima Ken Kumagai Shunsuke Yamada Masaichi Sotozawa Yutaka Inaba |
| author_facet | Shuntaro Nejima Ken Kumagai Shunsuke Yamada Masaichi Sotozawa Yutaka Inaba |
| author_sort | Shuntaro Nejima |
| collection | DOAJ |
| description | Abstract Background To evaluate the expected postoperative total leg length change using preoperative radiographs during surgical planning of four different methods of double level osteotomy (DLO). Methods This study included 34 patients (44 knees) who underwent DLO for varus knee osteoarthritis. Surgical planning was performed so that the postoperative weight bearing line ratio was 62.5%. In DLO, lateral closed or medial open wedge distal femoral osteotomy (LCWDFO, MOWDFO) was performed so that the postoperative mechanical lateral distal femoral angle was 85°, and residual deformity was corrected with medial open or lateral closed wedge high tibial osteotomy (MOWHTO, LCWHTO). Pre- and surgical planning X-rays in the one-leg standing position were compared to assess the change in leg length, and the factors affecting it, in the various surgical groups. The proportion of cases in which Δ total leg length was greater than 6 mm (symptomatic change) was investigated. Results The mean postoperative total leg length increased significantly with LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, while it decreased with LCWDFO + LCWHTO. The proportion of cases with a postoperative total leg length change > 6 mm was 72.7%, 2.3%, 100%, and 6.8% in LCWDFO + MOWHTO, LCWDFO + LCWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, respectively. In addition, the preoperative hip-knee-ankle angle correlated negatively with the postoperative total leg length change in LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, but not in LCWDFO + LCWHTO. Conclusions MOWDFO + MOWHTO had the largest postoperative leg length change and MOWDFO + LCWHTO had the smallest. Symptomatic leg length change (> 6 mm) should be considered in MOWDFO + MOWHTO and LCWDFO + MOWHTO. |
| first_indexed | 2024-03-09T15:05:22Z |
| format | Article |
| id | doaj.art-deb4eb75cd454297adb99900f80872c5 |
| institution | Directory Open Access Journal |
| issn | 2234-2451 |
| language | English |
| last_indexed | 2024-03-09T15:05:22Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Knee Surgery & Related Research |
| spelling | doaj.art-deb4eb75cd454297adb99900f80872c52023-11-26T13:41:57ZengBMCKnee Surgery & Related Research2234-24512023-09-013511810.1186/s43019-023-00198-yRadiologic simulation of leg length change after double level osteotomy in preoperative surgical planningShuntaro Nejima0Ken Kumagai1Shunsuke Yamada2Masaichi Sotozawa3Yutaka Inaba4Department of Orthopaedic Surgery, Yokohama City University School of MedicineDepartment of Orthopaedic Surgery, Yokohama City University School of MedicineDepartment of Orthopaedic Surgery, Yokohama City University School of MedicineDepartment of Orthopaedic Surgery, Yokohama City University School of MedicineDepartment of Orthopaedic Surgery, Yokohama City University School of MedicineAbstract Background To evaluate the expected postoperative total leg length change using preoperative radiographs during surgical planning of four different methods of double level osteotomy (DLO). Methods This study included 34 patients (44 knees) who underwent DLO for varus knee osteoarthritis. Surgical planning was performed so that the postoperative weight bearing line ratio was 62.5%. In DLO, lateral closed or medial open wedge distal femoral osteotomy (LCWDFO, MOWDFO) was performed so that the postoperative mechanical lateral distal femoral angle was 85°, and residual deformity was corrected with medial open or lateral closed wedge high tibial osteotomy (MOWHTO, LCWHTO). Pre- and surgical planning X-rays in the one-leg standing position were compared to assess the change in leg length, and the factors affecting it, in the various surgical groups. The proportion of cases in which Δ total leg length was greater than 6 mm (symptomatic change) was investigated. Results The mean postoperative total leg length increased significantly with LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, while it decreased with LCWDFO + LCWHTO. The proportion of cases with a postoperative total leg length change > 6 mm was 72.7%, 2.3%, 100%, and 6.8% in LCWDFO + MOWHTO, LCWDFO + LCWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, respectively. In addition, the preoperative hip-knee-ankle angle correlated negatively with the postoperative total leg length change in LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, but not in LCWDFO + LCWHTO. Conclusions MOWDFO + MOWHTO had the largest postoperative leg length change and MOWDFO + LCWHTO had the smallest. Symptomatic leg length change (> 6 mm) should be considered in MOWDFO + MOWHTO and LCWDFO + MOWHTO.https://doi.org/10.1186/s43019-023-00198-yHigh tibial osteotomyDouble level osteotomyDistal femoral osteotomyLeg length change |
| spellingShingle | Shuntaro Nejima Ken Kumagai Shunsuke Yamada Masaichi Sotozawa Yutaka Inaba Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning Knee Surgery & Related Research High tibial osteotomy Double level osteotomy Distal femoral osteotomy Leg length change |
| title | Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning |
| title_full | Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning |
| title_fullStr | Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning |
| title_full_unstemmed | Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning |
| title_short | Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning |
| title_sort | radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning |
| topic | High tibial osteotomy Double level osteotomy Distal femoral osteotomy Leg length change |
| url | https://doi.org/10.1186/s43019-023-00198-y |
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