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Risk factors and preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To investigate risk factors and suggest preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy (MOWHTO).

Methods

A total of 133 consecutive patients who underwent MOWHTO were retrospectively enrolled. Patients were divided into two groups based on postoperative medial proximal tibial angle (post-MPTA) of 95°: control group (n = 111, 83.5%) with post-MPTA less than 95° and excessive MPTA group (n = 22, 16.5%) with post-MPTA 95° or more. Demographics, radiographic parameters [mechanical lateral distal femoral angle (mLDFA), MPTA, posterior tibial slope, joint line obliquity (JLO), hip-knee-ankle angle, joint line convergence angle (JLCA), weight bearing line ratio, and correction angle], and clinical outcomes of patients were compared. Multiple logistic regression analysis was performed to determine risk factors for post-MPTA 95° or more.

Results

Multiple logistic regression analysis showed that preoperative JLO ≥ 3° [odds ratio (OR) 6.940, 95% confidence interval (CI) 2.373–20.296, p < 0.001] and preoperative JLCA ≥ 5° (OR 5.723, 95% CI 1.833–17.865, p = 0.008) were statistically significant risk factors for post-MPTA ≥ 95°. Incidences of excessive MPTA following MOWHTO in patients with none, one, and two risk factors preoperatively were 3.7%, 26.7%, and 77.8%, respectively.

Conclusion

Preoperative JLO ≥ 3° and JLCA ≥ 5° were two significant risk factors for excessive MPTA following MOWHTO. Thus, surgeon should consider other types of osteotomy if these two risk factors are present together preoperatively in MOWHTO candidates.

Level of evidence

Level III.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea

    Sueen Sohn

  2. Department of Orthopaedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    In Jun Koh

  3. Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Man Soo Kim & Yong In

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  1. Sueen Sohn
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  2. In Jun Koh
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  4. Yong In
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Correspondence to Yong In.

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All authors of this study declare that there is no conflict of interest relevant to this study.

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All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee, the 1964 Helsinki Declaration, and its later amendments or comparable ethical standards. This study was approved by IRB of Seoul St. Mary’s Hospital, the Catholic University of Korea (Study No.: KC17REDI0368).

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Sohn, S., Koh, I.J., Kim, M.S. et al. Risk factors and preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy. Arch Orthop Trauma Surg 142, 561–569 (2022). https://doi.org/10.1007/s00402-020-03660-8

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  • DOI: https://doi.org/10.1007/s00402-020-03660-8

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