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Alignment Adjustment Using The Valgus Stress Technique Can Increase The Surgical Accuracy Of Novice Surgeons During Medial Opening-Wedge High Tibial Osteotomy

2021 Congress Paper Abstracts

Alignment Adjustment Using The Valgus Stress Technique Can Increase The Surgical Accuracy Of Novice Surgeons During Medial Opening-Wedge High Tibial Osteotomy

Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Yong Gyu Sung, MD, KOREA, REPUBLIC OF Dong-Chul Park, MD, KOREA, REPUBLIC OF Jae Jung Kim, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF

Seoul St. Mary's Hospital, Seoul, Seoul, KOREA, REPUBLIC OF

2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Knee

Anatomic Structure

Bones Cartilage

Diagnosis / Condition

Osteoarthritis Arthritis

Treatment / Technique

Osteotomy

Patient Populations

Elderly

Diagnosis Method

X-ray

Sports Medicine

Practice Management Outcome Studies

Cartilage

Cartilage Treatment

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Summary: Adhering to the “alignment adjustment under valgus stress technique” protocol enabled novice surgeons to achieve similar surgical accuracy as that of an expert surgeon in coronal alignment during MOWHTO.

Introduction

The purpose of this study was to compare the degree of accuracy of coronal alignment correction with use of the “alignment adjustment under valgus stress technique” between expert and novice surgeons during medial opening-wedge high tibial osteotomy (MOWHTO).

Methods

Forty-eight patients who underwent MOWHTO performed by an expert surgeon (expert group) and 29 by a novice surgeon (novice group) were enrolled in analysis. During surgery, lower-extremity alignment was corrected using the “alignment adjustment under valgus stress technique”. Normocorrection was defined as a weight-bearing line ratio between 55% and 70% and the correction accuracy was compared between expert and novice groups using the ratio of normocorrection to outliers. The clinical outcomes were also compared using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at one year after surgery.

Results

The undercorrection rate was 14.6% in the expert group and 13.8% in the novice group, while the overcorrection rate was 2.1% in the expert group and 3.4% in the novice group. In the ratio of normocorrection to outliers, no difference was found between the two groups at the one-year follow-up visit (83.3% in the expert group vs. 82.8% in the novice group; p > 0.05). Also, no significant differences were seen in WOMAC subscores immediately preoperatively and at one year after surgery (all p > 0.05).

Conclusion

Adhering to the “alignment adjustment under valgus stress technique” protocol enabled novice surgeons to achieve similar surgical accuracy as that of an expert surgeon in coronal alignment during MOWHTO.

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