• Arch Orthop Trauma Surg · Aug 2021

    Factors related to the early outcome of medial open wedge high tibial osteotomy: coronal limb alignment affects more than cartilage degeneration state.

    • Sang-June Lee, Jae-Hwa Kim, and Wonchul Choi.
    • Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 13496, Korea.
    • Arch Orthop Trauma Surg. 2021 Aug 1; 141 (8): 1339-1348.

    IntroductionThis study aimed to identify possible factors influencing the early outcome after medial open wedge high tibial osteotomy (MOWHTO).Materials And MethodsA total of 87 MOWHTO cases with a minimum of 2-year follow-up and second-look arthroscopic results available were enrolled. The cartilage degeneration state was evaluated by the International Cartilage Repair Society (ICRS) grading. Radiographic parameters including the hip-knee-ankle axis (HKA), medial proximal tibia angle (MPTA), posterior tibial slope, patellar height, mechanical lateral distal femoral angle (LDFA), joint line convergence angle (JLCA), joint line obliquity (JLO), and weight-bearing line ratio (WBLR) were measured. The pre-operative arthritic change was evaluated by Kellgren-Lawrence (KL) classification. According to the post-operative HKA, knees were divided into three (Under/Optimal/Over-correction) subgroups. Subjective International Knee Documentation Committee (IKDC) scores were evaluated and factors related to post-operative IKDC scores were analyzed.ResultsThe pre-operative HKA (P = 0.002), post-operative HKA (P = 0.007), pre-operative MPTA (P = 0.011), and pre-operative WBLR (P = 0.031) were significantly related to the post-operative IKDC score. Cartilage degeneration states evaluated from first and second-look arthroscopy were not associated with post-operative IKDC score. Subgroup analysis revealed that the Under-correction group had significantly lower post-operative IKDC scores compared to the Optimal and Over-correction group (P = 0.012 and P = 0.030, respectively).ConclusionOur result suggests that a sub-optimal correction of coronal limb alignment negatively affects the early outcome of MOWHTO. On the other hand, the effect of the degree of cartilage degeneration was not significant.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

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