Discrepancy of alignment in different weight bearing conditions before and after high tibial osteotomy

• Published in: International orthopaedics 2017-01, Vol.41 (1), p.85-92
• Main Authors: Wang, Joon Ho, Shin, Jung Min, Kim, Hyun Ho, Kang, Seung-Hoon, Lee, Byung Hoon
• Format: Article
• Language: English
• Subjects: Adult; Bone Malalignment - etiology; Bone Malalignment - surgery; Female; Humans; Joint Deformities, Acquired - etiology; Joint Deformities, Acquired - surgery; Knee Joint - physiopathology; Knee Joint - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Orthopedics; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - surgery; Osteotomy - adverse effects; Prospective Studies; Tibia - surgery; Weight-Bearing; Young Adult
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-016-3279-z

Purpose To evaluate the differences in the amount of varus malalignment and valgus (over) correction in relation to three different weight bearing conditions from whole leg AP radiographs (single-limb (SL) stance, double-limb (DL) stance, supine position (S)) before and after high tibial osteotomy (HTO), and to evaluate which alignment parameters affect the changes for patients in three different weight bearing conditions. Methods A total of 40 consecutive patients (43 knees) with varus osteoarthritis underwent navigation assisted open wedge HTO. Mechanical axis angle (MA) was measured before and after surgery from hip-to-ankle radiographs taken with patients in three different weight bearing conditions. To find significant factors that affect the alignment differences, several variables including patient demographics, soft tissue laxity, pelvic obliquity, and ground mechanical axis deviation of tibia (calculated by the angle between two lines, tibial anatomical axis and weight-bearing line) were evaluated. Results Pre-operatively, mean MA measured on SL stance radiographs was significantly more varus than on DL stance (10.1° ± 2.4° and 8.0° ± 2.6°, respectively, p