Change of leg length after closed wedge high tibial osteotomy and associated factors

被引:0
作者
Sakurai, Kotaro [1 ]
Kumagai, Ken [1 ]
Nejima, Shuntaro [1 ]
Choe, Hyonmin [1 ]
Inaba, Yutaka [1 ]
机构
[1] Yokohama City Univ, Grad Sch Med, Dept Orthopaed Surg, 3-9 Fukuura,Kanazawa Ku, Yokohama 2360004, Japan
来源
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH | 2025年 / 20卷 / 01期
关键词
Closed wedge high tibial osteotomy; Leg length; Flexion contracture; Posterior tibial slope; RANDOMIZED CONTROLLED-TRIAL; OPENING-WEDGE; LIMB LENGTH; KNEE ARTHROPLASTY; CLOSING-WEDGE; OSTEOARTHRITIS; DISCREPANCY; INEQUALITY; OUTCOMES;
D O I
10.1186/s13018-025-05582-w
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective The purpose of this study was to investigate the distribution of the change of leg length (LL) after closed wedge high tibial osteotomy (CWHTO) and to identify the factors associated with the magnitude of postoperative change of LL. Methods A total of 70 consecutive knees of 58 patients with knee osteoarthritis who underwent CWHTO were retrospectively investigated. LL, hip-knee-ankle angle (HKAA), mechanical axis deviation (MAD), joint line convergence angle (JLCA), mechanical medial proximal tibial angle (mMPTA), and mechanical lateral distal femoral angle (mLDFA) were measured using the anteroposterior whole leg radiograph, and posterior tibial slope (PTS) and flexion contracture (FC) were measured using the lateral knee radiograph. The amount of change from preoperative to postoperative in each parameter was defined as Delta. Results Patients had a mean correction angle of 18.3 +/- 6.6 degrees, with a mean Delta LL of -0.8 +/- 10.2 mm, ranging from - 22 mm to 24 mm. There were significant differences between the preoperative and postoperative mean values of HKAA, MAD, JLCA, mMPTA, and FC, whereas no significant differences were found in LL, mLDFA, and PTS. A significant correlation was found between Delta LL and postoperative FC (rho=-0.28, P = 0.03). Moderate correlations were found between postoperative FC and preoperative FC (rho = 0.61, P < 0.01) or postoperative PTS (rho = 0.44, P < 0.01) and between Delta FC and postoperative FC (rho = 0.54, P < 0.01), postoperative PTS (rho = 0.60, P < 0.01) or Delta PTS (rho = 0.55, P < 0.01). Conclusions The mean change of LL after CWHTO was only - 0.8 mm, but it ranged widely, from - 22 mm to 24 mm. This variability highlights the importance of addressing factors such as FC and PTS, which are associated with LL changes. Surgeons should carefully control PTS during surgery and address FC to minimize LL change. However, these findings should be interpreted with caution due to the limited methodologies in the assessment of variables including LL and FC.
引用
收藏
页数:9
相关论文
共 27 条
[1]   Change in limb length after high tibial osteotomy using computer-assisted surgery: a comparative study of closed- and open-wedge osteotomies [J].
Bae, Dae Kyung ;
Song, Sang Jun ;
Kim, Hwan Jin ;
Seo, Jae Wan .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2013, 21 (01) :120-126
[2]   Total Knee Arthroplasty After High Tibial Osteotomy [J].
Cerciello, Simone ;
Vasso, Michele ;
Maffulli, Nicola ;
Neyret, Philippe ;
Corona, Katia ;
Panni, Alfredo Schiavone .
ORTHOPEDICS, 2014, 37 (03) :191-198
[3]   The Patterns of Limb Length, Height, Weight and Body Mass Index Changes after Total Knee Arthroplasty [J].
Chang, Moon Jong ;
Kang, Yeon Gwi ;
Chang, Chong Bum ;
Seong, Sang Cheol ;
Kim, Tae Kyun .
JOURNAL OF ARTHROPLASTY, 2013, 28 (10) :1856-1861
[4]   Predictors and Functional Implications of Change in Leg Length After Total Knee Arthroplasty [J].
Chinnappa, Jason ;
Chen, Darren B. ;
Harris, Ian A. ;
MacDessi, Samuel J. .
JOURNAL OF ARTHROPLASTY, 2017, 32 (09) :2725-+
[5]   PROXIMAL TIBIAL OSTEOTOMY - A CRITICAL LONG-TERM STUDY OF 87 CASES [J].
COVENTRY, MB ;
ILSTRUP, DM ;
WALLRICHS, SL .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1993, 75A (02) :196-201
[6]   Comparison of Closing-Wedge and Opening-Wedge High Tibial Osteotomy for Medial Compartment Osteoarthritis of the Knee A Randomized Controlled Trial with a Six-Year Follow-up [J].
Duivenvoorden, T. ;
Brouwer, R. W. ;
Baan, A. ;
Bos, P. K. ;
Reijman, M. ;
Bierma-Zeinstra, S. M. A. ;
Verhaar, J. A. N. .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2014, 96A (17) :1425-1432
[7]   Simultaneous arthroscopic implantation of autologous chondrocytes and high tibial osteotomy for tibial chondral defects in the varus knee [J].
Franceschi, Francesco ;
Longo, Umile Giuseppe ;
Ruzzini, Laura ;
Marinozzi, Andrea ;
Maffulli, Nicola ;
Denaro, Vincenzo .
KNEE, 2008, 15 (04) :309-313
[8]   Sports activities after lower limb osteotomy [J].
Gougoulias, Nikolaos ;
Khanna, Anil ;
Maffulli, Nicola .
BRITISH MEDICAL BULLETIN, 2009, 91 (01) :111-121
[9]   Association of Leg-Length Inequality With Knee Osteoarthritis A Cohort Study [J].
Harvey, William F. ;
Yang, Mei ;
Cooke, Theodore D. V. ;
Segal, Neil A. ;
Lane, Nancy ;
Lewis, Cora E. ;
Felson, David T. .
ANNALS OF INTERNAL MEDICINE, 2010, 152 (05) :287-W92
[10]   High-risk factors for subjective discomfort due to lower limb discrepancy after medial open wedge high tibial osteotomy [J].
He, Axiang ;
Wang, Yin ;
Chen, Yanan ;
Zhou, Ying ;
Zhang, Hui ;
Mao, Yanjie ;
Liu, Wanjun ;
Zhang, Xianlong .
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2021, 16 (01)