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Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis

PURPOSE: To investigate the effect of the ratio of the medial tibial plateau width to the total tibial plateau width on the therapeutic efficacy of high tibial osteotomy (HTO) on the medial side for the treatment of knee osteoarthritis. METHODS: In this study, we retrospectively analyzed information...

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Autores principales: Yuan, Long, Niu, Shuaishuai, Zhai, Chuanxing, Li, Sen, Bian, Jichao, Zhao, Xiaowei, Zhang, Yuanmin, Wang, Guodong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107279/
https://www.ncbi.nlm.nih.gov/pubmed/35562799
http://dx.doi.org/10.1186/s12893-022-01629-5
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author Yuan, Long
Niu, Shuaishuai
Zhai, Chuanxing
Li, Sen
Bian, Jichao
Zhao, Xiaowei
Zhang, Yuanmin
Wang, Guodong
author_facet Yuan, Long
Niu, Shuaishuai
Zhai, Chuanxing
Li, Sen
Bian, Jichao
Zhao, Xiaowei
Zhang, Yuanmin
Wang, Guodong
author_sort Yuan, Long
collection PubMed
description PURPOSE: To investigate the effect of the ratio of the medial tibial plateau width to the total tibial plateau width on the therapeutic efficacy of high tibial osteotomy (HTO) on the medial side for the treatment of knee osteoarthritis. METHODS: In this study, we retrospectively analyzed information of 278 patients who underwent medial HTO for knee osteoarthritis with varus deformity. The Tinetti Gait and Balance Assessment Tool, the Visual Analog Scale (VAS), and the Knee Society Scoring System (KSS) were used to comprehensively evaluate the function of the knee joint after HTO. RESULTS: After adjusting for potential confounding factors (i.e., age, gender, body mass index/BMI, and surgical site), the Tinetti assessment score was optimized when the degree of correction was 53.67%, with the β-value on the left and right sides of the inflection point of 0.49 (confidence interval, CI: 0.20, 0.78, P = 0.0009) and− 0.26 (95% CI: − 0.30, − 0.22, P < 0.0001), respectively. The KSS score was optimized when the degree of correction was 55.45%, with the β-value on the left and right sides of the inflection point of 2.77 (95% CI: 1.64, 3.90, P < 0.0001) and − 1.18 (95% CI: − 1.46, − 0.91, P < 0.0001), respectively. The VAS score was the lowest when the degree of correction was 55.00%, with the β-value on the left and right sides of the inflection point of − 0.16 (95% CI: − 0.29, − 0.03, P = 0.0146) and 0.08 (95% CI: 0.05, 0.10, P < 0.0001), respectively. Stratified analysis showed that the BMI affected the Tinetti assessment score (β =  − 0.14, 95% CI: − 0.24, − 0.04, P = 0.0071). According to the smooth-curve fitting results, when the BMI was > 28, the Tinetti assessment score showed a negative trend. CONCLUSION: The degree of lower-limb mechanical axis correction correlated with the functional status of the knee joint after MOW HTO. When the ratio of the medial tibial plateau width to the total tibial plateau width was approximately 55%, the post-MOW HTO outcomes were optimized and the patients experienced the highest satisfaction. In addition, very high BMI was not conducive for the postoperative recovery of the knee joint function. Level of evidence: III Case–control study/Retrospective comparative study.
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spelling pubmed-91072792022-05-15 Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis Yuan, Long Niu, Shuaishuai Zhai, Chuanxing Li, Sen Bian, Jichao Zhao, Xiaowei Zhang, Yuanmin Wang, Guodong BMC Surg Research PURPOSE: To investigate the effect of the ratio of the medial tibial plateau width to the total tibial plateau width on the therapeutic efficacy of high tibial osteotomy (HTO) on the medial side for the treatment of knee osteoarthritis. METHODS: In this study, we retrospectively analyzed information of 278 patients who underwent medial HTO for knee osteoarthritis with varus deformity. The Tinetti Gait and Balance Assessment Tool, the Visual Analog Scale (VAS), and the Knee Society Scoring System (KSS) were used to comprehensively evaluate the function of the knee joint after HTO. RESULTS: After adjusting for potential confounding factors (i.e., age, gender, body mass index/BMI, and surgical site), the Tinetti assessment score was optimized when the degree of correction was 53.67%, with the β-value on the left and right sides of the inflection point of 0.49 (confidence interval, CI: 0.20, 0.78, P = 0.0009) and− 0.26 (95% CI: − 0.30, − 0.22, P < 0.0001), respectively. The KSS score was optimized when the degree of correction was 55.45%, with the β-value on the left and right sides of the inflection point of 2.77 (95% CI: 1.64, 3.90, P < 0.0001) and − 1.18 (95% CI: − 1.46, − 0.91, P < 0.0001), respectively. The VAS score was the lowest when the degree of correction was 55.00%, with the β-value on the left and right sides of the inflection point of − 0.16 (95% CI: − 0.29, − 0.03, P = 0.0146) and 0.08 (95% CI: 0.05, 0.10, P < 0.0001), respectively. Stratified analysis showed that the BMI affected the Tinetti assessment score (β =  − 0.14, 95% CI: − 0.24, − 0.04, P = 0.0071). According to the smooth-curve fitting results, when the BMI was > 28, the Tinetti assessment score showed a negative trend. CONCLUSION: The degree of lower-limb mechanical axis correction correlated with the functional status of the knee joint after MOW HTO. When the ratio of the medial tibial plateau width to the total tibial plateau width was approximately 55%, the post-MOW HTO outcomes were optimized and the patients experienced the highest satisfaction. In addition, very high BMI was not conducive for the postoperative recovery of the knee joint function. Level of evidence: III Case–control study/Retrospective comparative study. BioMed Central 2022-05-13 /pmc/articles/PMC9107279/ /pubmed/35562799 http://dx.doi.org/10.1186/s12893-022-01629-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Yuan, Long
Niu, Shuaishuai
Zhai, Chuanxing
Li, Sen
Bian, Jichao
Zhao, Xiaowei
Zhang, Yuanmin
Wang, Guodong
Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis
title Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis
title_full Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis
title_fullStr Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis
title_full_unstemmed Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis
title_short Influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis
title_sort influence of lower-limb mechanical axis on the curative effect of medial high tibial osteotomy for knee osteoarthritis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107279/
https://www.ncbi.nlm.nih.gov/pubmed/35562799
http://dx.doi.org/10.1186/s12893-022-01629-5
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