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High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition
Purpose The purpose of this study was to: (1) test the hypothesis that HTO improves articular cartilage composition in the medial compartment without adversely affecting the lateral compartment and patella, and; (2) explore associations between knee alignment and cartilage composition after surgery....
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| Published in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2022-03, Vol.30 (3), p.1065-1074 |
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| container_issue | 3 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
| container_volume | 30 |
| creator | Atkinson, Hayden F. Birmingham, Trevor B. Schulz, Jenna M. Primeau, Codie A. Leitch, Kristyn M. Pritchett, Stephany L. Holdsworth, D. W. Giffin, J. R. |
| description | Purpose
The purpose of this study was to: (1) test the hypothesis that HTO improves articular cartilage composition in the medial compartment without adversely affecting the lateral compartment and patella, and; (2) explore associations between knee alignment and cartilage composition after surgery.
Methods
3T MRI and standing radiographs were obtained from 34 patients before and 1-year after HTO. Articular cartilage was segmented from T2 maps. Mechanical axis angle (MAA), posterior tibial slope, and patellar height were measured from radiographs. Changes in T2 and radiographic measures were assessed using paired
t
tests, and associations were assessed using Pearson correlation coefficients.
Results
The mean (SD) MAA before and after HTO was − 6.5° (2.4) and 0.6° (3.0), respectively. There was statistically significant shortening [mean (95%CI)] of T2 in the medial femur [− 2.8 ms (− 4.2; − 1.3),
p
|
| doi_str_mv | 10.1007/s00167-021-06516-9 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2501851202</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2501851202</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-dcaccb098b7e84ea51d0fd4daf80d6982638ff25a2e35eb16febc3d93f8cab4f3</originalsourceid><addsrcrecordid>eNp9kE1PAyEQhonRaK3-AQ-Go5fVAfbzaBq1JiZe9ExYdqjU3aUCa9J_L7Xq0RMT5pk3Mw8hFwyuGUB1EwBYWWXAWQZlwcqsOSAzlguRVSKvDskMmpxnHIryhJyGsAZIZd4ckxMhKi7KQsyIXNrVG422taqnLkR00Q1bGh0dcYo-farersYBx0jtsPHuEwMdsNvh7yMiVT5aPfXKU70re7VCqt2wccFG68YzcmRUH_D8552T1_u7l8Uye3p-eFzcPmU6rRqzTiutW2jqtsI6R1WwDkyXd8rU0JVNzUtRG8MLxVEU2LLSYKtF1whTa9XmRszJ1T43rfgxYYhysEFj36sR3RQkL4DVBePAE8r3qPYuBI9GbrwdlN9KBnInVu7FyiRWfouVTRq6_Mmf2nT-38ivyQSIPRBSa1yhl2s3-THd_F_sF8ljhsE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2501851202</pqid></control><display><type>article</type><title>High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition</title><source>EBSCOhost SPORTDiscus with Full Text</source><source>Springer Nature</source><source>Wiley-Blackwell Read & Publish Collection</source><creator>Atkinson, Hayden F. ; Birmingham, Trevor B. ; Schulz, Jenna M. ; Primeau, Codie A. ; Leitch, Kristyn M. ; Pritchett, Stephany L. ; Holdsworth, D. W. ; Giffin, J. R.</creator><creatorcontrib>Atkinson, Hayden F. ; Birmingham, Trevor B. ; Schulz, Jenna M. ; Primeau, Codie A. ; Leitch, Kristyn M. ; Pritchett, Stephany L. ; Holdsworth, D. W. ; Giffin, J. R.</creatorcontrib><description>Purpose
The purpose of this study was to: (1) test the hypothesis that HTO improves articular cartilage composition in the medial compartment without adversely affecting the lateral compartment and patella, and; (2) explore associations between knee alignment and cartilage composition after surgery.
Methods
3T MRI and standing radiographs were obtained from 34 patients before and 1-year after HTO. Articular cartilage was segmented from T2 maps. Mechanical axis angle (MAA), posterior tibial slope, and patellar height were measured from radiographs. Changes in T2 and radiographic measures were assessed using paired
t
tests, and associations were assessed using Pearson correlation coefficients.
Results
The mean (SD) MAA before and after HTO was − 6.5° (2.4) and 0.6° (3.0), respectively. There was statistically significant shortening [mean (95%CI)] of T2 in the medial femur [− 2.8 ms (− 4.2; − 1.3),
p
< 0.001] and medial tibia [− 2.2 ms (− 3.3; − 1.0),
p
< 0.001], without changes in the lateral femur [− 0.5 ms (− 1.6; 0.6),
p
= 0.3], lateral tibia [0.2 ms (− 0.8; 1.1),
p
= NS], or patella [0.5 ms (− 1.0; 2.1),
p
= NS). Associations between radiographic measures and T2 were low. 23% of the increase in lateral femur T2 was explained by postoperative posterior tibial slope (
r
= 0.48).
Conclusion
Performing medial opening wedge HTO without overcorrection improves articular cartilage composition in the medial compartment of the knee without compromising the lateral compartment or the patella. Although further research is required, these results suggest HTO is a disease structure-modifying treatment for knee OA.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-021-06516-9</identifier><identifier>PMID: 33723653</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cartilage, Articular - diagnostic imaging ; Cartilage, Articular - surgery ; Humans ; Knee ; Knee Joint - diagnostic imaging ; Knee Joint - surgery ; Medicine ; Medicine & Public Health ; Orthopedics ; Osteoarthritis, Knee - diagnostic imaging ; Osteoarthritis, Knee - surgery ; Osteotomy - methods ; Patella - diagnostic imaging ; Patella - surgery ; Sports Medicine ; Tibia - diagnostic imaging ; Tibia - surgery</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022-03, Vol.30 (3), p.1065-1074</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2021</rights><rights>2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-dcaccb098b7e84ea51d0fd4daf80d6982638ff25a2e35eb16febc3d93f8cab4f3</citedby><cites>FETCH-LOGICAL-c347t-dcaccb098b7e84ea51d0fd4daf80d6982638ff25a2e35eb16febc3d93f8cab4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33723653$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Atkinson, Hayden F.</creatorcontrib><creatorcontrib>Birmingham, Trevor B.</creatorcontrib><creatorcontrib>Schulz, Jenna M.</creatorcontrib><creatorcontrib>Primeau, Codie A.</creatorcontrib><creatorcontrib>Leitch, Kristyn M.</creatorcontrib><creatorcontrib>Pritchett, Stephany L.</creatorcontrib><creatorcontrib>Holdsworth, D. W.</creatorcontrib><creatorcontrib>Giffin, J. R.</creatorcontrib><title>High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
The purpose of this study was to: (1) test the hypothesis that HTO improves articular cartilage composition in the medial compartment without adversely affecting the lateral compartment and patella, and; (2) explore associations between knee alignment and cartilage composition after surgery.
Methods
3T MRI and standing radiographs were obtained from 34 patients before and 1-year after HTO. Articular cartilage was segmented from T2 maps. Mechanical axis angle (MAA), posterior tibial slope, and patellar height were measured from radiographs. Changes in T2 and radiographic measures were assessed using paired
t
tests, and associations were assessed using Pearson correlation coefficients.
Results
The mean (SD) MAA before and after HTO was − 6.5° (2.4) and 0.6° (3.0), respectively. There was statistically significant shortening [mean (95%CI)] of T2 in the medial femur [− 2.8 ms (− 4.2; − 1.3),
p
< 0.001] and medial tibia [− 2.2 ms (− 3.3; − 1.0),
p
< 0.001], without changes in the lateral femur [− 0.5 ms (− 1.6; 0.6),
p
= 0.3], lateral tibia [0.2 ms (− 0.8; 1.1),
p
= NS], or patella [0.5 ms (− 1.0; 2.1),
p
= NS). Associations between radiographic measures and T2 were low. 23% of the increase in lateral femur T2 was explained by postoperative posterior tibial slope (
r
= 0.48).
Conclusion
Performing medial opening wedge HTO without overcorrection improves articular cartilage composition in the medial compartment of the knee without compromising the lateral compartment or the patella. Although further research is required, these results suggest HTO is a disease structure-modifying treatment for knee OA.</description><subject>Cartilage, Articular - diagnostic imaging</subject><subject>Cartilage, Articular - surgery</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Osteoarthritis, Knee - diagnostic imaging</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Osteotomy - methods</subject><subject>Patella - diagnostic imaging</subject><subject>Patella - surgery</subject><subject>Sports Medicine</subject><subject>Tibia - diagnostic imaging</subject><subject>Tibia - surgery</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kE1PAyEQhonRaK3-AQ-Go5fVAfbzaBq1JiZe9ExYdqjU3aUCa9J_L7Xq0RMT5pk3Mw8hFwyuGUB1EwBYWWXAWQZlwcqsOSAzlguRVSKvDskMmpxnHIryhJyGsAZIZd4ckxMhKi7KQsyIXNrVG422taqnLkR00Q1bGh0dcYo-farersYBx0jtsPHuEwMdsNvh7yMiVT5aPfXKU70re7VCqt2wccFG68YzcmRUH_D8552T1_u7l8Uye3p-eFzcPmU6rRqzTiutW2jqtsI6R1WwDkyXd8rU0JVNzUtRG8MLxVEU2LLSYKtF1whTa9XmRszJ1T43rfgxYYhysEFj36sR3RQkL4DVBePAE8r3qPYuBI9GbrwdlN9KBnInVu7FyiRWfouVTRq6_Mmf2nT-38ivyQSIPRBSa1yhl2s3-THd_F_sF8ljhsE</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Atkinson, Hayden F.</creator><creator>Birmingham, Trevor B.</creator><creator>Schulz, Jenna M.</creator><creator>Primeau, Codie A.</creator><creator>Leitch, Kristyn M.</creator><creator>Pritchett, Stephany L.</creator><creator>Holdsworth, D. W.</creator><creator>Giffin, J. R.</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20220301</creationdate><title>High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition</title><author>Atkinson, Hayden F. ; Birmingham, Trevor B. ; Schulz, Jenna M. ; Primeau, Codie A. ; Leitch, Kristyn M. ; Pritchett, Stephany L. ; Holdsworth, D. W. ; Giffin, J. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-dcaccb098b7e84ea51d0fd4daf80d6982638ff25a2e35eb16febc3d93f8cab4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cartilage, Articular - diagnostic imaging</topic><topic>Cartilage, Articular - surgery</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Osteoarthritis, Knee - diagnostic imaging</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Osteotomy - methods</topic><topic>Patella - diagnostic imaging</topic><topic>Patella - surgery</topic><topic>Sports Medicine</topic><topic>Tibia - diagnostic imaging</topic><topic>Tibia - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Atkinson, Hayden F.</creatorcontrib><creatorcontrib>Birmingham, Trevor B.</creatorcontrib><creatorcontrib>Schulz, Jenna M.</creatorcontrib><creatorcontrib>Primeau, Codie A.</creatorcontrib><creatorcontrib>Leitch, Kristyn M.</creatorcontrib><creatorcontrib>Pritchett, Stephany L.</creatorcontrib><creatorcontrib>Holdsworth, D. W.</creatorcontrib><creatorcontrib>Giffin, J. R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Atkinson, Hayden F.</au><au>Birmingham, Trevor B.</au><au>Schulz, Jenna M.</au><au>Primeau, Codie A.</au><au>Leitch, Kristyn M.</au><au>Pritchett, Stephany L.</au><au>Holdsworth, D. W.</au><au>Giffin, J. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>30</volume><issue>3</issue><spage>1065</spage><epage>1074</epage><pages>1065-1074</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
The purpose of this study was to: (1) test the hypothesis that HTO improves articular cartilage composition in the medial compartment without adversely affecting the lateral compartment and patella, and; (2) explore associations between knee alignment and cartilage composition after surgery.
Methods
3T MRI and standing radiographs were obtained from 34 patients before and 1-year after HTO. Articular cartilage was segmented from T2 maps. Mechanical axis angle (MAA), posterior tibial slope, and patellar height were measured from radiographs. Changes in T2 and radiographic measures were assessed using paired
t
tests, and associations were assessed using Pearson correlation coefficients.
Results
The mean (SD) MAA before and after HTO was − 6.5° (2.4) and 0.6° (3.0), respectively. There was statistically significant shortening [mean (95%CI)] of T2 in the medial femur [− 2.8 ms (− 4.2; − 1.3),
p
< 0.001] and medial tibia [− 2.2 ms (− 3.3; − 1.0),
p
< 0.001], without changes in the lateral femur [− 0.5 ms (− 1.6; 0.6),
p
= 0.3], lateral tibia [0.2 ms (− 0.8; 1.1),
p
= NS], or patella [0.5 ms (− 1.0; 2.1),
p
= NS). Associations between radiographic measures and T2 were low. 23% of the increase in lateral femur T2 was explained by postoperative posterior tibial slope (
r
= 0.48).
Conclusion
Performing medial opening wedge HTO without overcorrection improves articular cartilage composition in the medial compartment of the knee without compromising the lateral compartment or the patella. Although further research is required, these results suggest HTO is a disease structure-modifying treatment for knee OA.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33723653</pmid><doi>10.1007/s00167-021-06516-9</doi><tpages>10</tpages></addata></record> |
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| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022-03, Vol.30 (3), p.1065-1074 |
| issn | 0942-2056 1433-7347 |
| language | eng |
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| source | EBSCOhost SPORTDiscus with Full Text; Springer Nature; Wiley-Blackwell Read & Publish Collection |
| subjects | Cartilage, Articular - diagnostic imaging Cartilage, Articular - surgery Humans Knee Knee Joint - diagnostic imaging Knee Joint - surgery Medicine Medicine & Public Health Orthopedics Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - surgery Osteotomy - methods Patella - diagnostic imaging Patella - surgery Sports Medicine Tibia - diagnostic imaging Tibia - surgery |
| title | High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition |
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