Knee Surg Relat Res.  2018 Dec;30(4):311-318. 10.5792/ksrr.18.035.

Does Coronal Knee and Ankle Alignment Affect Recurrence of the Varus Deformity after High Tibial Osteotomy?

• Lee OS
• Lee SH
• Lee YS

• KMID: 2438111
• DOI: http://doi.org/10.5792/ksrr.18.035

Abstract

PURPOSE
The purpose of this study was to evaluate changes in the coronal alignment of the knee and ankle joints after open wedge high tibial osteotomy (OWHTO) to determine factors related to the recurrence (R) of the varus deformity by serial analysis.
MATERIALS AND METHODS
Sixty-four OWHTOs were enrolled in this study. The weight bearing line (WBL) ratio, joint line convergence angle (JLCA), knee joint inclination, mechanical axis-tibial plateau angle, talar inclination (TI), and distal tibia articular angle (DTAA) were serially assessed. Serial correlation analysis between all parameters was performed. Patients were divided into R group and no recurrence (NR) group according to the WBL ratio (55%) at postoperative one year.
RESULTS
The preoperative WBL ratio showed significantly negative correlation with serial changes of JLCA, TI, and DTAA (p < 0.05). The JLCA, TI, and DTAA as well as WBL ratio showed a significantly larger degree of varus alignment in the R group than in NR group at postoperative 6 weeks and 1 year after OWHTO (p < 0.05).
CONCLUSIONS
Sufficient correction of the WBL and restoration of the JLCA during OWHTO are essential to prevention of the R of varus deformity after the surgery because they are the only modifiable factors during surgery. LEVEL OF EVIDENCE: IV, Case series

Keyword

Knee; Osteoarthritis; Varus deformity; Osteotomy; Recurrence

MeSH Terms

Ankle Joint
Ankle*
Congenital Abnormalities*
Humans
Joints
Knee Joint
Knee*
Osteoarthritis
Osteotomy*
Recurrence*
Tibia
Weight-Bearing