Intraoperative Fluoroscopic Assessment of Limb Alignment is a Reliable Predictor for Postoperative Limb Alignment in Biplanar Medial Opening-Wedge High Tibial Osteotomy

Ki-Mo Jang, Jong Hee Lee, Il Youp Cho, Bong Kyung Park, Seung Beom Han

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The purpose of this study was to assess the reliability of pre-, intra operative, and postoperative limb alignment measurements and investigate the correlation between the measurements in biplanar medial opening-wedge high tibial osteotomy. Methods This study enrolled 59 knees undergoing biplanar opening-wedge high tibial osteotomy for primary medial osteoarthritis with varus deformity. Preoperative and postoperative standing lower leg radiographs and intraoperative fluoroscopic images were taken. Two independent examiners analyzed the radiologic data to assess lower limb alignment and mechanical axis (MA) deviation (percentage of MA position on tibial plateau). The effect of preoperative hip-knee-ankle angle and MA deviation, age, sex, body mass index (BMI), and joint line convergence angle on the discrepancy between intraoperative and postoperative MA deviation was analyzed. Results The mean preoperative hip-knee-ankle angle and MA deviation were varus 7.7 ± 3.3° and 14.1 ± 15.1%, respectively. After osteotomy, the mean intraoperative postosteotomy MA deviation was 57.9 ± 2.1% in supine position, and the mean post-operative MA deviation increased to 63.9 ± 2.9% on standing radiographs. The mean difference between intraoperative postosteotomy MA deviation and postoperative MA deviation was 6.1 ± 2.2%. Linear regression analysis between intraoperative postosteotomy MA deviation and postoperative MA deviation showed a statistically significant linear relationship (R2 = 0.449; P < .001). Multivariate regression analysis revealed that preoperative joint line convergence angle (β = 0.856; P < .001) and BMI (β = 0.349; P < .001) were significant positive predictors for the difference in MA deviation. Conclusion There was a significant linear relationship between intraoperative postosteotomy MA deviation and postoperative MA deviation following biplanar medial opening-wedge high tibial osteotomy. A greater discrepancy between MA deviations was significantly associated with higher BMI and joint line convergence angle.

Original languageEnglish
Pages (from-to)756-760
Number of pages5
JournalJournal of Arthroplasty
Volume32
Issue number3
DOIs
Publication statusPublished - 2017 Mar 1

Fingerprint

Osteotomy
Extremities
Knee
Body Mass Index
Joints
Ankle
Hip
Paraphilic Disorders
Regression Analysis
Supine Position
Osteoarthritis
Lower Extremity
Linear Models
Leg
Multivariate Analysis

Keywords

  • high tibial osteotomy
  • intraoperative lower limb alignment
  • knee joint
  • medial compartmental osteoarthritis
  • postoperative lower limb alignment

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Intraoperative Fluoroscopic Assessment of Limb Alignment is a Reliable Predictor for Postoperative Limb Alignment in Biplanar Medial Opening-Wedge High Tibial Osteotomy. / Jang, Ki-Mo; Lee, Jong Hee; Cho, Il Youp; Park, Bong Kyung; Han, Seung Beom.

In: Journal of Arthroplasty, Vol. 32, No. 3, 01.03.2017, p. 756-760.

Research output: Contribution to journalArticle

@article{b8c7080353d043fabfb60a462e1bb7a3,
title = "Intraoperative Fluoroscopic Assessment of Limb Alignment is a Reliable Predictor for Postoperative Limb Alignment in Biplanar Medial Opening-Wedge High Tibial Osteotomy",
abstract = "Background The purpose of this study was to assess the reliability of pre-, intra operative, and postoperative limb alignment measurements and investigate the correlation between the measurements in biplanar medial opening-wedge high tibial osteotomy. Methods This study enrolled 59 knees undergoing biplanar opening-wedge high tibial osteotomy for primary medial osteoarthritis with varus deformity. Preoperative and postoperative standing lower leg radiographs and intraoperative fluoroscopic images were taken. Two independent examiners analyzed the radiologic data to assess lower limb alignment and mechanical axis (MA) deviation (percentage of MA position on tibial plateau). The effect of preoperative hip-knee-ankle angle and MA deviation, age, sex, body mass index (BMI), and joint line convergence angle on the discrepancy between intraoperative and postoperative MA deviation was analyzed. Results The mean preoperative hip-knee-ankle angle and MA deviation were varus 7.7 ± 3.3° and 14.1 ± 15.1{\%}, respectively. After osteotomy, the mean intraoperative postosteotomy MA deviation was 57.9 ± 2.1{\%} in supine position, and the mean post-operative MA deviation increased to 63.9 ± 2.9{\%} on standing radiographs. The mean difference between intraoperative postosteotomy MA deviation and postoperative MA deviation was 6.1 ± 2.2{\%}. Linear regression analysis between intraoperative postosteotomy MA deviation and postoperative MA deviation showed a statistically significant linear relationship (R2 = 0.449; P < .001). Multivariate regression analysis revealed that preoperative joint line convergence angle (β = 0.856; P < .001) and BMI (β = 0.349; P < .001) were significant positive predictors for the difference in MA deviation. Conclusion There was a significant linear relationship between intraoperative postosteotomy MA deviation and postoperative MA deviation following biplanar medial opening-wedge high tibial osteotomy. A greater discrepancy between MA deviations was significantly associated with higher BMI and joint line convergence angle.",
keywords = "high tibial osteotomy, intraoperative lower limb alignment, knee joint, medial compartmental osteoarthritis, postoperative lower limb alignment",
author = "Ki-Mo Jang and Lee, {Jong Hee} and Cho, {Il Youp} and Park, {Bong Kyung} and Han, {Seung Beom}",
year = "2017",
month = "3",
day = "1",
doi = "10.1016/j.arth.2016.08.022",
language = "English",
volume = "32",
pages = "756--760",
journal = "Journal of Arthroplasty",
issn = "0883-5403",
publisher = "Churchill Livingstone",
number = "3",

}

TY - JOUR

T1 - Intraoperative Fluoroscopic Assessment of Limb Alignment is a Reliable Predictor for Postoperative Limb Alignment in Biplanar Medial Opening-Wedge High Tibial Osteotomy

AU - Jang, Ki-Mo

AU - Lee, Jong Hee

AU - Cho, Il Youp

AU - Park, Bong Kyung

AU - Han, Seung Beom

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background The purpose of this study was to assess the reliability of pre-, intra operative, and postoperative limb alignment measurements and investigate the correlation between the measurements in biplanar medial opening-wedge high tibial osteotomy. Methods This study enrolled 59 knees undergoing biplanar opening-wedge high tibial osteotomy for primary medial osteoarthritis with varus deformity. Preoperative and postoperative standing lower leg radiographs and intraoperative fluoroscopic images were taken. Two independent examiners analyzed the radiologic data to assess lower limb alignment and mechanical axis (MA) deviation (percentage of MA position on tibial plateau). The effect of preoperative hip-knee-ankle angle and MA deviation, age, sex, body mass index (BMI), and joint line convergence angle on the discrepancy between intraoperative and postoperative MA deviation was analyzed. Results The mean preoperative hip-knee-ankle angle and MA deviation were varus 7.7 ± 3.3° and 14.1 ± 15.1%, respectively. After osteotomy, the mean intraoperative postosteotomy MA deviation was 57.9 ± 2.1% in supine position, and the mean post-operative MA deviation increased to 63.9 ± 2.9% on standing radiographs. The mean difference between intraoperative postosteotomy MA deviation and postoperative MA deviation was 6.1 ± 2.2%. Linear regression analysis between intraoperative postosteotomy MA deviation and postoperative MA deviation showed a statistically significant linear relationship (R2 = 0.449; P < .001). Multivariate regression analysis revealed that preoperative joint line convergence angle (β = 0.856; P < .001) and BMI (β = 0.349; P < .001) were significant positive predictors for the difference in MA deviation. Conclusion There was a significant linear relationship between intraoperative postosteotomy MA deviation and postoperative MA deviation following biplanar medial opening-wedge high tibial osteotomy. A greater discrepancy between MA deviations was significantly associated with higher BMI and joint line convergence angle.

AB - Background The purpose of this study was to assess the reliability of pre-, intra operative, and postoperative limb alignment measurements and investigate the correlation between the measurements in biplanar medial opening-wedge high tibial osteotomy. Methods This study enrolled 59 knees undergoing biplanar opening-wedge high tibial osteotomy for primary medial osteoarthritis with varus deformity. Preoperative and postoperative standing lower leg radiographs and intraoperative fluoroscopic images were taken. Two independent examiners analyzed the radiologic data to assess lower limb alignment and mechanical axis (MA) deviation (percentage of MA position on tibial plateau). The effect of preoperative hip-knee-ankle angle and MA deviation, age, sex, body mass index (BMI), and joint line convergence angle on the discrepancy between intraoperative and postoperative MA deviation was analyzed. Results The mean preoperative hip-knee-ankle angle and MA deviation were varus 7.7 ± 3.3° and 14.1 ± 15.1%, respectively. After osteotomy, the mean intraoperative postosteotomy MA deviation was 57.9 ± 2.1% in supine position, and the mean post-operative MA deviation increased to 63.9 ± 2.9% on standing radiographs. The mean difference between intraoperative postosteotomy MA deviation and postoperative MA deviation was 6.1 ± 2.2%. Linear regression analysis between intraoperative postosteotomy MA deviation and postoperative MA deviation showed a statistically significant linear relationship (R2 = 0.449; P < .001). Multivariate regression analysis revealed that preoperative joint line convergence angle (β = 0.856; P < .001) and BMI (β = 0.349; P < .001) were significant positive predictors for the difference in MA deviation. Conclusion There was a significant linear relationship between intraoperative postosteotomy MA deviation and postoperative MA deviation following biplanar medial opening-wedge high tibial osteotomy. A greater discrepancy between MA deviations was significantly associated with higher BMI and joint line convergence angle.

KW - high tibial osteotomy

KW - intraoperative lower limb alignment

KW - knee joint

KW - medial compartmental osteoarthritis

KW - postoperative lower limb alignment

UR - http://www.scopus.com/inward/record.url?scp=84995752813&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995752813&partnerID=8YFLogxK

U2 - 10.1016/j.arth.2016.08.022

DO - 10.1016/j.arth.2016.08.022

M3 - Article

C2 - 27667532

AN - SCOPUS:84995752813

VL - 32

SP - 756

EP - 760

JO - Journal of Arthroplasty

JF - Journal of Arthroplasty

SN - 0883-5403

IS - 3

ER -