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Medial proximal tibial angle at the posterior tibial plateau represents the pre-arthritic constitutional medial proximal tibial angle in anterior cruciate ligament-intact, advanced osteoarthritis of the knee

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

In kinematically aligned total knee arthroplasty (TKA), it is necessary to infer the pre-arthritic constitutional medial proximal tibial angle (MPTA) in advanced osteoarthritis (OA) of the knee with bone loss. The aim of this study was to investigate whether MPTA at the posterior tibial plateau represents the pre-arthritic constitutional MPTA in anterior cruciate ligament (ACL)-intact, advanced OA knees. It was hypothesized that MPTA at the posterior tibial plateau represents the pre-arthritic constitutional MPTA of ACL-intact, advanced knee OA.

Methods

One hundred varus, anterior cruciate ligament (ACL)-intact, advanced OA knees were analysed. The hip–knee–ankle (HKA) angle and MPTA were assessed on computed radiography (CR) and MPTAs at the anterior, middle, and posterior part of the tibial plateau were assessed on computed tomography (CT) images. The association between these parameters was also analysed.

Results

CR images showed an HKA angle of 172.4 ± 4.1° and MPTA of 84.3 ± 2.5°. CT images showed different MPTAs in the three regions, ranging from 83.9 ± 2.4° to 85.9 ± 2.8°. The middle MPTA was the lowest at 83.9 ± 2.4°. HKA angle correlated with the middle MPTA (r = 0.3355, 95% confidence interval [CI] 0.1489–0.4991, p = 0.0006) and ΔMPTA (Middle-Posterior) (r = 0.5128, 95% CI 0.3518–0.6443, p < 0.0001).

Conclusion

The MPTA at the posterior tibial plateau represents the pre-arthritic constitutional MPTA in ACL-intact, advanced OA knees.

Level of evidence

III, retrospective cohort study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Hayashi-machi 6-85-1, Ogaki, Gifu, 503-0015, Japan

    Hiroyasu Ogawa, Yutaka Nakamura, Masaya Sengoku, Tetsuya Shimokawa, Kazuki Sohmiya & Kazuichiro Ohnishi

  2. Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan

    Hiroyasu Ogawa, Kazu Matsumoto & Haruhiko Akiyama

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  1. Hiroyasu Ogawa
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Contributions

HO: study design, data collection and analysis, statistical analysis, initial draft preparation. YN, KS, MS, TS, KO: initial draft preparation and data collection. KM, HA: initial draft preparation. All authors read and approved the final version of the paper.

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Correspondence to Hiroyasu Ogawa.

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None of the authors have any conflicts of interest to declare.

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No external funding was received for this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This cross-sectional study was approved by the Institutional Review Board of Ogaki Tokushukai Group (Approval number TGE01668-066).

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Ogawa, H., Nakamura, Y., Sengoku, M. et al. Medial proximal tibial angle at the posterior tibial plateau represents the pre-arthritic constitutional medial proximal tibial angle in anterior cruciate ligament-intact, advanced osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 30, 2941–2947 (2022). https://doi.org/10.1007/s00167-022-06890-y

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