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Reliability Of Preoperative Planning Method Considering Latent Medial Joint Laxity In Medial Open-Wedge High Tibial Osteotomy

Dong Jin Ryu, MD, PhD.
KOREA, REPUBLIC OF

Reliability Of Preoperative Planning Method Considering Latent Medial Joint Laxity In Medial Open-Wedge High Tibial Osteotomy

Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF Kyeuback Kwon, MD, KOREA, REPUBLIC OF Myung Ku Kim, MD, KOREA, REPUBLIC OF Youngsik Jeon, MD, KOREA, REPUBLIC OF Byoungyoul Kang, KOREA, REPUBLIC OF Joon Ho Wang, MD, PhD, KOREA, REPUBLIC OF

SAMSUNG medical center, Seoul, Seoul, KOREA, REPUBLIC OF

2021 Congress ePoster Presentation Not yet rated

Anatomic Location

Knee

Anatomic Structure

Cartilage

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Osteotomy

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Summary: An equation that is considering medial laxity could help to set a preoperative planning for optimal correction during MOWHTO.

Background

Soft tissue laxity around the knee joint has been recognized as a crucial factor affecting correction error during medial open-wedge high tibial osteotomy (MOWHTO). Particularly, the medial laxity, representing the changes in joint line convergence angle (JLCA), affects the soft tissue correction.

Hypothesis/Purpose: Quantify the medial laxity and develop a preoperative planning method that considers the medial laxity.

Methods

This study retrospectively reviewed 139 knees in 117 patients who underwent navigation-assisted MOWHTO from January 2014 to July 2019, for symptomatic medial compartment osteoarthritis with varus alignment >5°. We compared the results of two different preoperative planning methods used: 1) conventional Miniaci and 2) latent medial laxity reduction. We evaluated the incidence of under-correction, acceptable correction, and over-correction. The radiologic parameters were analyzed using the multiple linear regression with a stepwise selection model to establish an equation for the optimal preoperative planning method.

Results

The Miniaci method showed a higher incidence of over-correction (55.3%) than the latent medial laxity reduction method (22.8%) at postoperative 6 months (p=0.0006). The multiple linear regression with a stepwise selection model revealed a high correlation coefficient for the following equation: adjusted preoperative planning correction angle = 0.596 + 0.891 x target correction angle (TCA) - 0.255 x ?JLCA valgus (R2= 0.888). On simplifying, TCA – 1/3?JLCA valgus showed the highest intraclass coefficient (ICC) value (0.991) with the proposed equation. While, the Miniaci method showed a relatively low ICC value of 0.875.

Conclusion

The Conventional Miniaci method has a risk of over-correction after MOWHTO. An equation that is considering medial laxity could help to set a preoperative planning for optimal correction during MOWHTO.

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Reliability Of Preoperative Planning Method Considering Latent Medial Joint Laxity In Medial Open-Wedge High Tibial Osteotomy

Reliability Of Preoperative Planning Method Considering Latent Medial Joint Laxity In Medial Open-Wedge High Tibial Osteotomy

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Reliability Of Preoperative Planning Method Considering Latent Medial Joint Laxity In Medial Open-Wedge High Tibial Osteotomy

Reliability Of Preoperative Planning Method Considering Latent Medial Joint Laxity In Medial Open-Wedge High Tibial Osteotomy

Background

Methods

Results

Conclusion