Differences in preoperative planning for high-tibial osteotomy between the standing and supine positions View Full Text


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Article Info

DATE

2021-03-01

AUTHORS

Takehiko Matsushita, Shu Watanabe, Daisuke Araki, Kanto Nagai, Yuichi Hoshino, Noriyuki Kanzaki, Tomoyuki Matsumoto, Takahiro Niikura, Ryosuke Kuroda

ABSTRACT

IntroductionPrevious studies have reported that alignment changes depend on the patient’s position in orthopedic surgery. However, it has not yet been well examined how the patient’s position affects the preoperative planning in high-tibial osteotomy (HTO). Therefore, the aim of this study was to investigate the effects of the patient’s position on preoperative planning in HTO.Materials and methodsA total of 60 knees in 55 patients who underwent HTO were retrospectively examined. Virtual preoperative planning for medial open-wedge HTO (OWHTO), lateral closed-wedge HTO (CWHTO), and hybrid CWHTO were performed by setting the percentage of the weight-bearing line (%WBL) at 62% as an optimal alignment. The correction angle differences between the supine and standing radiographs were measured. The virtual %WBL (v%WBL) was determined by applying the correction angle obtained from the standing radiograph to the supine radiograph. The %WBL discrepancy (%WBLd) was calculated as v%WBL − 62 (%) to predict the possible correction errors during surgeries. A single regression analysis was performed to examine the correlation between the correction angle difference and %WBLd.ResultsThe mean correction angle was significantly higher when the preoperative planning was based on standing radiographs than when based on supine radiographs (P < 0.001), and the mean difference was 2.2 ± 1.5°. The difference between the two conditions in the medial opening gaps for OWHTO, lateral wedge sizes (mm) for CWHTO, and hybrid CWHTO were 2.6 ± 2.0, 2.3 ± 1.6, and 1.9 ± 1.4, respectively. The mean v%WBL was 71.2% ± 7.3%, and the mean %WBLd was 10.1% ± 7.4%. A single regression analysis revealed a linear correlation between the correction angle difference and %WBLd (%WBLd = 4.72 × correction angle difference + 0.08). No statistically significant difference in the parameters was found between the supine and standing radiographs postoperatively.ConclusionsWe found significant differences in the estimated correction angles between the supine and standing radiographs in the planning for HTO. Therefore, surgeons should carefully consider the difference between supine and standing radiographs and estimate the possible correction error during surgery when planning a HTO. More... »

PAGES

8

References to SciGraph publications

  • 2019-04-12. Preoperative latent medial laxity and correction angle are crucial factors for overcorrection in medial open-wedge high tibial osteotomy in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
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  • 2017-11-30. Satisfactory functional and radiological outcomes can be expected in young patients under 45 years old after open wedge high tibial osteotomy in a long-term follow-up in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2016-12-01. Comparison of Cable Method and Miniaci Method Using Picture Archiving and Communication System in Preoperative Planning for Open Wedge High Tibial Osteotomy in KNEE SURGERY & RELATED RESEARCH
  • 2019-07-09. Difference in joint line convergence angle between the supine and standing positions is the most important predictive factor of coronal correction error after medial opening wedge high tibial osteotomy in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2019-11-28. Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2018-03-30. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2016-08-18. Discrepancy of alignment in different weight bearing conditions before and after high tibial osteotomy in INTERNATIONAL ORTHOPAEDICS
  • 2017-06-07. Intraoperative adjustment of alignment under valgus stress reduces outliers in patients undergoing medial opening-wedge high tibial osteotomy in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2019-12-11. Patient-specific prediction of joint line convergence angle after high tibial osteotomy using a whole-leg radiograph standing on lateral-wedge insole in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2018-12-01. Short-Term Results of Hybrid Closed-Wedge High Tibial Osteotomy: A Case Series with a Minimum 3-Year Follow-up in KNEE SURGERY & RELATED RESEARCH
  • 2015-07-08. Effect of soft tissue laxity of the knee joint on limb alignment correction in open-wedge high tibial osteotomy in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2016-07-21. Preoperative varus laxity correlates with overcorrection in medial opening wedge high tibial osteotomy in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1186/s43019-021-00090-7

    DOI

    http://dx.doi.org/10.1186/s43019-021-00090-7

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33648604


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        "description": "IntroductionPrevious studies have reported that alignment changes depend on the patient\u2019s position in orthopedic surgery. However, it has not yet been well examined how the patient\u2019s position affects the preoperative planning in high-tibial osteotomy (HTO). Therefore, the aim of this study was to investigate the effects of the patient\u2019s position on preoperative planning in HTO.Materials and methodsA total of 60 knees in 55 patients who underwent HTO were retrospectively examined. Virtual preoperative planning for medial open-wedge HTO (OWHTO), lateral closed-wedge HTO (CWHTO), and hybrid CWHTO were performed by setting the percentage of the weight-bearing line (%WBL) at 62% as an optimal alignment. The correction angle differences between the supine and standing radiographs were measured. The virtual %WBL (v%WBL) was determined by applying the correction angle obtained from the standing radiograph to the supine radiograph. The %WBL discrepancy (%WBLd) was calculated as v%WBL\u2009\u2212\u200962 (%) to predict the possible correction errors during surgeries. A single regression analysis was performed to examine the correlation between the correction angle difference and %WBLd.ResultsThe mean correction angle was significantly higher when the preoperative planning was based on standing radiographs than when based on supine radiographs (P\u2009<\u20090.001), and the mean difference was 2.2\u2009\u00b1\u20091.5\u00b0. The difference between the two conditions in the medial opening gaps for OWHTO, lateral wedge sizes (mm) for CWHTO, and hybrid CWHTO were 2.6\u2009\u00b1\u20092.0, 2.3\u2009\u00b1\u20091.6, and 1.9\u2009\u00b1\u20091.4, respectively. The mean v%WBL was 71.2%\u2009\u00b1\u20097.3%, and the mean %WBLd was 10.1%\u2009\u00b1\u20097.4%. A single regression analysis revealed a linear correlation between the correction angle difference and %WBLd (%WBLd\u2009=\u20094.72\u2009\u00d7\u2009correction angle difference\u2009+\u20090.08). No statistically significant difference in the parameters was found between the supine and standing radiographs postoperatively.ConclusionsWe found significant differences in the estimated correction angles between the supine and standing radiographs in the planning for HTO. Therefore, surgeons should carefully consider the difference between supine and standing radiographs and estimate the possible correction error during surgery when planning a HTO.", 
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    19 schema:description IntroductionPrevious studies have reported that alignment changes depend on the patient’s position in orthopedic surgery. However, it has not yet been well examined how the patient’s position affects the preoperative planning in high-tibial osteotomy (HTO). Therefore, the aim of this study was to investigate the effects of the patient’s position on preoperative planning in HTO.Materials and methodsA total of 60 knees in 55 patients who underwent HTO were retrospectively examined. Virtual preoperative planning for medial open-wedge HTO (OWHTO), lateral closed-wedge HTO (CWHTO), and hybrid CWHTO were performed by setting the percentage of the weight-bearing line (%WBL) at 62% as an optimal alignment. The correction angle differences between the supine and standing radiographs were measured. The virtual %WBL (v%WBL) was determined by applying the correction angle obtained from the standing radiograph to the supine radiograph. The %WBL discrepancy (%WBLd) was calculated as v%WBL − 62 (%) to predict the possible correction errors during surgeries. A single regression analysis was performed to examine the correlation between the correction angle difference and %WBLd.ResultsThe mean correction angle was significantly higher when the preoperative planning was based on standing radiographs than when based on supine radiographs (P < 0.001), and the mean difference was 2.2 ± 1.5°. The difference between the two conditions in the medial opening gaps for OWHTO, lateral wedge sizes (mm) for CWHTO, and hybrid CWHTO were 2.6 ± 2.0, 2.3 ± 1.6, and 1.9 ± 1.4, respectively. The mean v%WBL was 71.2% ± 7.3%, and the mean %WBLd was 10.1% ± 7.4%. A single regression analysis revealed a linear correlation between the correction angle difference and %WBLd (%WBLd = 4.72 × correction angle difference + 0.08). No statistically significant difference in the parameters was found between the supine and standing radiographs postoperatively.ConclusionsWe found significant differences in the estimated correction angles between the supine and standing radiographs in the planning for HTO. Therefore, surgeons should carefully consider the difference between supine and standing radiographs and estimate the possible correction error during surgery when planning a HTO.
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    27 IntroductionPrevious studies
    28 WBL
    29 aim
    30 alignment
    31 alignment changes
    32 analysis
    33 angle
    34 angle difference
    35 changes
    36 closed-wedge HTO
    37 closed-wedge high tibial osteotomy
    38 conditions
    39 correction angle
    40 correction error
    41 correlation
    42 differences
    43 discrepancy
    44 effect
    45 error
    46 gap
    47 high tibial osteotomy
    48 knee
    49 lateral closed wedge high tibial osteotomy
    50 linear correlation
    51 lines
    52 materials
    53 mean correction angle
    54 mean difference
    55 means
    56 medial open-wedge high tibial osteotomy
    57 medial opening gap
    58 methodsA total
    59 open wedge HTO
    60 open-wedge high tibial osteotomy
    61 opening gap
    62 optimal alignment
    63 orthopedic surgery
    64 osteotomy
    65 parameters
    66 patient position
    67 patients
    68 percentage
    69 planning
    70 position
    71 preoperative planning
    72 radiographs
    73 regression analysis
    74 significant differences
    75 single regression analysis
    76 size
    77 standing
    78 standing radiographs
    79 study
    80 supine
    81 supine position
    82 supine radiographs
    83 surgeons
    84 surgery
    85 total
    86 virtual preoperative planning
    87 wedge size
    88 weight-bearing line
    89 schema:name Differences in preoperative planning for high-tibial osteotomy between the standing and supine positions
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