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Progression of pelvic retroversion is a critical factor for clinical outcome after Opening-wedge high tibial osteotomy among elderly patients
Purpose To evaluate the clinical outcome after opening-wedge high tibial osteotomy (OWHTO) and to determine the critical factors for a poor clinical outcome after OWHTO in patients aged over 65 years. Methods Our retrospective analysis was based on the data from 233 patients who underwent OWHTO for...
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| Published in: | Journal of experimental orthopaedics 2021-08, Vol.8 (1), p.65-65, Article 65 |
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| creator | Otsuki, Shuhei Wakama, Hitoshi Ikeda, Kuniaki Okuno, Nobuhiro Okamoto, Yoshinori Okayoshi, Tomohiro Matsuyama, Junya Neo, Masashi |
| description | Purpose
To evaluate the clinical outcome after opening-wedge high tibial osteotomy (OWHTO) and to determine the critical factors for a poor clinical outcome after OWHTO in patients aged over 65 years.
Methods
Our retrospective analysis was based on the data from 233 patients who underwent OWHTO for medial compartment knee OA at our institution between January 2013 and December 2018, and 88 patients (36 men and 52 women) over 65 years of age were included in this study. Radiographic parameters of weight-bearing line ratio (WBLR) and pelvic inclination (PI); the knee function, range of motion (ROM) and extension; and clinical outcome with Lysholm score were obtained preoperatively and postoperatively at the final follow-up visit. To evaluate the critical factors for the clinical outcome, univariate regression analysis was used to identify the relationship between postoperative and improved Lysholm score and pre-and post-operative essential factors. To reveal the factor having a greater impact on the clinical outcome, a
p
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| doi_str_mv | 10.1186/s40634-021-00376-5 |
| format | article |
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To evaluate the clinical outcome after opening-wedge high tibial osteotomy (OWHTO) and to determine the critical factors for a poor clinical outcome after OWHTO in patients aged over 65 years.
Methods
Our retrospective analysis was based on the data from 233 patients who underwent OWHTO for medial compartment knee OA at our institution between January 2013 and December 2018, and 88 patients (36 men and 52 women) over 65 years of age were included in this study. Radiographic parameters of weight-bearing line ratio (WBLR) and pelvic inclination (PI); the knee function, range of motion (ROM) and extension; and clinical outcome with Lysholm score were obtained preoperatively and postoperatively at the final follow-up visit. To evaluate the critical factors for the clinical outcome, univariate regression analysis was used to identify the relationship between postoperative and improved Lysholm score and pre-and post-operative essential factors. To reveal the factor having a greater impact on the clinical outcome, a
p
< 0.05 in univariate factors was entered into a multivariate regression analysis.
Results
The preoperative WBLR was significantly changed, and Lysholm score improved from 59.5 to 81.5 (
p
< 0.0001), whereas the PI, knee extension and ROM were not changed after OWHTO. Regarding the essential factors affecting clinical outcome after OWHTO, age and delta PI were negative, whereas preoperative WBLR, postoperative ROM, especially extension, had a positive effect (
p
< 0.05). Furthermore, only delta PI had affected the improvement of clinical outcome with OWHTO (
p
< 0.01), and postoperative knee extension was negatively correlated with the progression of pelvic retroversion (
p
< 0.01).
Conclusion
Age at surgery and progression of pelvic retroversion were the critical factors for poor postoperative clinical outcomes after OWHTO. Care should be taken for the progression of pelvic retroversion after OWHTO because it deteriorates the clinical outcome by inducing the knee flexion contracture as the compensatory mechanism for the balance of sagittal alignment.</description><identifier>ISSN: 2197-1153</identifier><identifier>EISSN: 2197-1153</identifier><identifier>DOI: 10.1186/s40634-021-00376-5</identifier><identifier>PMID: 34409519</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Clinical outcomes ; Knee ; Medicine ; Medicine & Public Health ; Original Paper ; Orthopedics ; Regression analysis ; Surgical Orthopedics</subject><ispartof>Journal of experimental orthopaedics, 2021-08, Vol.8 (1), p.65-65, Article 65</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c584t-5c45a4cabf3efdeac0476e5b46c441fb95864746791c16dc1f10a35256329d9e3</citedby><cites>FETCH-LOGICAL-c584t-5c45a4cabf3efdeac0476e5b46c441fb95864746791c16dc1f10a35256329d9e3</cites><orcidid>0000-0002-2752-8484</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2562366782/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2562366782?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids></links><search><creatorcontrib>Otsuki, Shuhei</creatorcontrib><creatorcontrib>Wakama, Hitoshi</creatorcontrib><creatorcontrib>Ikeda, Kuniaki</creatorcontrib><creatorcontrib>Okuno, Nobuhiro</creatorcontrib><creatorcontrib>Okamoto, Yoshinori</creatorcontrib><creatorcontrib>Okayoshi, Tomohiro</creatorcontrib><creatorcontrib>Matsuyama, Junya</creatorcontrib><creatorcontrib>Neo, Masashi</creatorcontrib><title>Progression of pelvic retroversion is a critical factor for clinical outcome after Opening-wedge high tibial osteotomy among elderly patients</title><title>Journal of experimental orthopaedics</title><addtitle>J EXP ORTOP</addtitle><description>Purpose
To evaluate the clinical outcome after opening-wedge high tibial osteotomy (OWHTO) and to determine the critical factors for a poor clinical outcome after OWHTO in patients aged over 65 years.
Methods
Our retrospective analysis was based on the data from 233 patients who underwent OWHTO for medial compartment knee OA at our institution between January 2013 and December 2018, and 88 patients (36 men and 52 women) over 65 years of age were included in this study. Radiographic parameters of weight-bearing line ratio (WBLR) and pelvic inclination (PI); the knee function, range of motion (ROM) and extension; and clinical outcome with Lysholm score were obtained preoperatively and postoperatively at the final follow-up visit. To evaluate the critical factors for the clinical outcome, univariate regression analysis was used to identify the relationship between postoperative and improved Lysholm score and pre-and post-operative essential factors. To reveal the factor having a greater impact on the clinical outcome, a
p
< 0.05 in univariate factors was entered into a multivariate regression analysis.
Results
The preoperative WBLR was significantly changed, and Lysholm score improved from 59.5 to 81.5 (
p
< 0.0001), whereas the PI, knee extension and ROM were not changed after OWHTO. Regarding the essential factors affecting clinical outcome after OWHTO, age and delta PI were negative, whereas preoperative WBLR, postoperative ROM, especially extension, had a positive effect (
p
< 0.05). Furthermore, only delta PI had affected the improvement of clinical outcome with OWHTO (
p
< 0.01), and postoperative knee extension was negatively correlated with the progression of pelvic retroversion (
p
< 0.01).
Conclusion
Age at surgery and progression of pelvic retroversion were the critical factors for poor postoperative clinical outcomes after OWHTO. Care should be taken for the progression of pelvic retroversion after OWHTO because it deteriorates the clinical outcome by inducing the knee flexion contracture as the compensatory mechanism for the balance of sagittal alignment.</description><subject>Clinical outcomes</subject><subject>Knee</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Regression analysis</subject><subject>Surgical Orthopedics</subject><issn>2197-1153</issn><issn>2197-1153</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9ks2KFDEUhQtRnGGcF3AVcOOmNKncpFIbQQZ_BgbGha5DKnVTnaaq0ibpln4I39l09aCOCyEh4eacj3vDqaqXjL5hTMm3CajkUNOG1ZTyVtbiSXXZsK6tGRP86V_3i-o6pS2llHGgQrbPqwsOQDvBusvq55cYxogp-bCQ4MgOp4O3JGKO4YBxLftEDLHRZ2_NRJyxOUTiyraTX9Za2GcbZiTGZYzkfoeLX8b6Bw4jko0fNyT73p90KWPIYT4SM4dlJDgNGKcj2ZnsccnpRfXMmSnh9cN5VX37-OHrzef67v7T7c37u9oKBbkWFoQBa3rH0Q1oLIVWouhBWgDm-k4oCS3ItmOWycEyx6jhohGSN93QIb-qbs_cIZit3kU_m3jUwXi9FkIctYll3Ak1qK4H1XcOeluWUso4MUgzSNc6Cqqw3p1Zu30_42DLHNFMj6CPXxa_0WM4aMVboAwK4PUDIIbve0xZzz5ZnCazYNgnXdpuFOfQNEX66h_pNuzjUr5qVXEpW3VSNWeVjSGliO53M4zqU3j0OTy6hEev4dGimPjZlIp4GTH-Qf_H9QuKCMlG</recordid><startdate>20210818</startdate><enddate>20210818</enddate><creator>Otsuki, Shuhei</creator><creator>Wakama, Hitoshi</creator><creator>Ikeda, Kuniaki</creator><creator>Okuno, Nobuhiro</creator><creator>Okamoto, Yoshinori</creator><creator>Okayoshi, Tomohiro</creator><creator>Matsuyama, Junya</creator><creator>Neo, Masashi</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><general>Wiley</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2752-8484</orcidid></search><sort><creationdate>20210818</creationdate><title>Progression of pelvic retroversion is a critical factor for clinical outcome after Opening-wedge high tibial osteotomy among elderly patients</title><author>Otsuki, Shuhei ; Wakama, Hitoshi ; Ikeda, Kuniaki ; Okuno, Nobuhiro ; Okamoto, Yoshinori ; Okayoshi, Tomohiro ; Matsuyama, Junya ; Neo, Masashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c584t-5c45a4cabf3efdeac0476e5b46c441fb95864746791c16dc1f10a35256329d9e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Clinical outcomes</topic><topic>Knee</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Regression analysis</topic><topic>Surgical Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Otsuki, Shuhei</creatorcontrib><creatorcontrib>Wakama, Hitoshi</creatorcontrib><creatorcontrib>Ikeda, Kuniaki</creatorcontrib><creatorcontrib>Okuno, Nobuhiro</creatorcontrib><creatorcontrib>Okamoto, Yoshinori</creatorcontrib><creatorcontrib>Okayoshi, Tomohiro</creatorcontrib><creatorcontrib>Matsuyama, Junya</creatorcontrib><creatorcontrib>Neo, Masashi</creatorcontrib><collection>SpringerOpen</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest - Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of experimental orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Otsuki, Shuhei</au><au>Wakama, Hitoshi</au><au>Ikeda, Kuniaki</au><au>Okuno, Nobuhiro</au><au>Okamoto, Yoshinori</au><au>Okayoshi, Tomohiro</au><au>Matsuyama, Junya</au><au>Neo, Masashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Progression of pelvic retroversion is a critical factor for clinical outcome after Opening-wedge high tibial osteotomy among elderly patients</atitle><jtitle>Journal of experimental orthopaedics</jtitle><stitle>J EXP ORTOP</stitle><date>2021-08-18</date><risdate>2021</risdate><volume>8</volume><issue>1</issue><spage>65</spage><epage>65</epage><pages>65-65</pages><artnum>65</artnum><issn>2197-1153</issn><eissn>2197-1153</eissn><abstract>Purpose
To evaluate the clinical outcome after opening-wedge high tibial osteotomy (OWHTO) and to determine the critical factors for a poor clinical outcome after OWHTO in patients aged over 65 years.
Methods
Our retrospective analysis was based on the data from 233 patients who underwent OWHTO for medial compartment knee OA at our institution between January 2013 and December 2018, and 88 patients (36 men and 52 women) over 65 years of age were included in this study. Radiographic parameters of weight-bearing line ratio (WBLR) and pelvic inclination (PI); the knee function, range of motion (ROM) and extension; and clinical outcome with Lysholm score were obtained preoperatively and postoperatively at the final follow-up visit. To evaluate the critical factors for the clinical outcome, univariate regression analysis was used to identify the relationship between postoperative and improved Lysholm score and pre-and post-operative essential factors. To reveal the factor having a greater impact on the clinical outcome, a
p
< 0.05 in univariate factors was entered into a multivariate regression analysis.
Results
The preoperative WBLR was significantly changed, and Lysholm score improved from 59.5 to 81.5 (
p
< 0.0001), whereas the PI, knee extension and ROM were not changed after OWHTO. Regarding the essential factors affecting clinical outcome after OWHTO, age and delta PI were negative, whereas preoperative WBLR, postoperative ROM, especially extension, had a positive effect (
p
< 0.05). Furthermore, only delta PI had affected the improvement of clinical outcome with OWHTO (
p
< 0.01), and postoperative knee extension was negatively correlated with the progression of pelvic retroversion (
p
< 0.01).
Conclusion
Age at surgery and progression of pelvic retroversion were the critical factors for poor postoperative clinical outcomes after OWHTO. Care should be taken for the progression of pelvic retroversion after OWHTO because it deteriorates the clinical outcome by inducing the knee flexion contracture as the compensatory mechanism for the balance of sagittal alignment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34409519</pmid><doi>10.1186/s40634-021-00376-5</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-2752-8484</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Clinical outcomes Knee Medicine Medicine & Public Health Original Paper Orthopedics Regression analysis Surgical Orthopedics |
| title | Progression of pelvic retroversion is a critical factor for clinical outcome after Opening-wedge high tibial osteotomy among elderly patients |
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