Preoperative soft tissue laxity around knee was associated with less accurate alignment correction after hybrid closed-w
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KNEE
Preoperative soft tissue laxity around knee was associated with less accurate alignment correction after hybrid closed‑wedge high tibial osteotomy Shu Takagawa1 · Naomi Kobayashi1 · Yohei Yukizawa1 · Takayuki Oishi1 · Masaki Tsuji1 · Yutaka Inaba2 Received: 21 June 2019 / Accepted: 15 October 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose This study aimed to assess the effect of soft tissue correction due to knee joint laxity, which induces alignment error after hybrid closed-wedge high tibial osteotomy (CWHTO). In addition, to verify whether postoperative soft tissue correction can be predicted from preoperative radiographic parameters. Methods A retrospective evaluation of data from patients treated by CWHTO in 2016–2019 was performed. Standing fulllength anteroposterior radiograph measurement was performed pre- and post-surgery, and short anteroposterior radiographs of the knee under maximal manual varus and valgus stress were taken preoperatively. The weight-bearing line, hip–knee–ankle angle (HKA), medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA) were measured, in addition to JLCA under varus or valgus conditions. Soft tissue correction was defined as ΔHKA minus ΔMPTA. Multiple regression analysis was performed to evaluate preoperative factors that could influence soft tissue correction. Results Data from 49 knees were included in the analysis. The mean soft tissue correction was 3.2°, which indicates an over-correction. Multiple regression analysis revealed that JLCA (β = 0.642; p 0.85.
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Knee Surgery, Sports Traumatology, Arthroscopy
The reproducibility of all measurements was considered high.
Statistical analysis The paired t test was used to evaluate the differences in each radiographic parameter (pre- and post-WBL ratio, HKA angle, and JLCA). To analyse the preoperative factors that influence soft tissue correction and bony correction error, a regression analysis was performed. First, a simple regression analysis was performed using the following factors as explanatory variables: BMI, WBL, HKA, MPTA, JLCA, varus JLCA, valgus JLCA, ΔJLCA, and planned correction angle. Variables with a p value
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