Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Higuchi, Takashi; Koseki, Haruhiko; Yonekura, Akihiko; Chiba, Ko; Nakazoe, Yusuke; Sunagawa, Shinya; Noguchi, Chieko; Osaki, Makoto

doi:10.1186/s12891-019-2764-0

Cited by 26 publications

(25 citation statements)

References 54 publications

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“…The shape of tibia plateau (“pagoda-type”, determined by JLCA and MTPD) and advanced K/L grade were the indication criteria recommended by several reports and verified in our study [ 13 , 16 ]. However, to the best of our best knowledge, no study has taken the alignment of lower limb and the accurate value of the certain parameters into consideration.…”

Section: Discussionsupporting

confidence: 80%

“…During TCVO, we discovered that elevation of the medial tibia plateau could help recover the tension of MCL and subsequently loosen the LCL as the lower limb alignment was restored. Furthermore, a previous study also reported increased tension in the cruciate ligaments which contributed to increased joint stability [ 13 ]. Thus, TCVO does not require additional ligament reconstruction to improve joint stability and congruency.…”

Section: Discussionmentioning

confidence: 99%

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Salvage of severe knee osteoarthritis: efficacy of tibial condylar valgus osteotomy versus open wedge high tibial osteotomy

et al. 2021

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Introduction To compare the clinical outcomes and the radiographic features between tibial condylar valgus osteotomy (TCVO) and open wedge high tibial osteotomy (OWHTO). New insight into the indication criteria for TCVO was also clarified for achieving satisfactory results. Materials and methods Sixty-three knees with medial-compartment osteoarthritis were retrospectively studied. Thirty-four knees with subluxated lateral joint and depression of the medial tibial plateau underwent TCVO and the rest underwent OWHTO. Among the 63 knees included, 27 knees with a pre-operative femorotibial angle (FTA) ≥ 185° were defined as severe varus (subgroup S, 15 in STCVO group and 12 in SHTO group). Lower limb alignment, intra-, and extra-articular congruency were evaluated according to the radiograph obtained before and 24 months after surgery. The visual analog scale (VAS) score and Hospital for Special Surgery (HSS) score were obtained to assess the clinical results. Opening angle and distance of the opening gap in each group were measured by intra-operative fluoroscopy. Results During the 2-year follow-up period, the mean HSS score increased from 70.3 to 81.4 in HTO group and 65.9 to 87.3 in TCVO group (p < 0.05). The mean VAS score decreased from 5.9 to 2.6 and 6.0 to 2.1, respectively (p < 0.01). Pre-operative FTA was restored to 172.9° in HTO group and 171.3° in TCVO group, and percentage of mechanical axis (%MA) was improved to 59.7% and 61.2%, respectively. Joint line convergence angle (JLCA) was slightly restored and medial tibial plateau depression (MTPD) was relatively the same before and after OWHTO, while these parameters improved greatly (from 6.4° to 1.2° and − 8.0° to 5.9°, p < 0.01) in TCVO group. More undercorrected knees were observed in SHTO group than STCVO group (58.3% and 13.3%, p < 0.05). Opening angle and distance of the opening gap were larger in TCVO group (19.1° and 14.0 mm) than those in OWHTO group (9.3° and 10.1 mm, p < 0.05). Conclusion Compared to OWHTO, TCVO had priority in treating advanced knee OA with intra-articular deformity. However, TCVO had a limited capacity to correct the varus angle. Besides, TCVO might be suitable for medial-compartment OA with a pre-operative FTA ≥ 185°.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Salvage of severe knee osteoarthritis: efficacy of tibial condylar valgus osteotomy versus open wedge high tibial osteotomy

et al. 2021

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“…In normal knees, the JLCA ranges from 0° to 2°. 13 However, the parallel JLCA differs in patients with medial osteoarthritis because of varus alignment, with pseudolaxity of the lateral side resulting from substantial amounts of intra-articular cartilage loss in the medial compartment. 27 , 36 In medial laxity knees with varus alignment, the difference in values between JLCA while standing and on application of valgus force could be significantly large.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Preoperative Planning Method That Considers Latent Medial Joint Laxity in Medial Open-Wedge Proximal Tibial Osteotomy

Ryu

Lee

Jung

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Soft tissue laxity around the knee joint has been recognized as a crucial factor affecting correction error during medial open-wedge proximal tibial osteotomy (MOWPTO). Medial laxity in particular, which represents the changes in joint-line convergence angle (JLCA), affects soft tissue correction. Purpose: The purpose of this study was to quantify medial laxity and develop a preoperative planning method that considers medial laxity. Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively reviewed 139 knees in 117 patients who underwent navigation-assisted MOWPTO from January 2014 to July 2019 for symptomatic medial compartment osteoarthritis with varus alignment >5°. We compared the results of 2 preoperative planning methods: conventional Miniaci (n = 47) and latent medial laxity reduction (LMLR) (n = 92). We evaluated the incidence of undercorrection, acceptable correction, and overcorrection. The radiologic parameters were analyzed using multiple linear regression with a stepwise selection model to establish an equation for the optimal preoperative planning method. The intraclass correlation coefficients (ICCs) of intraobserver, interobserver, and intermethod reliability were calculated. Results: The Miniaci method showed a higher incidence of overcorrection (55.3%) than the LMLR method (22.8%) at postoperative 6 months ( P = .0006). Multiple linear regression with a stepwise selection model revealed a high correlation coefficient ( R 2 = 0.888) for the following equation: Adjusted planned correction angle = 0.596 + 0.891 × Target correction angle – 0.255 × Δ JLCA valgus. Upon simplification, the following equation showed the highest intermethod ICC value (0.991): Target correction angle – ⅓Δ JLCA valgus, while the Miniaci method showed a relatively low ICC value of 0.875. Conclusion: There was a risk of overcorrection after MOWPTO using the conventional Miniaci method. An equation that considers medial laxity may help during preoperative planning for optimal correction during MOWPTO.

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“…The image of the right knee joint revealed grade 4 OA on the Kellgren-Lawrence scoring system, with a bone defect in the medial tibia. The shape of the tibial plateau was a pagoda-type, and the medial tibial plateau depression (MTPD) [3] was −40 °(Figure 2). Full-length radiography of the lower limbs showed pelvic tilt and genu varum, with a femorotibial angle of 182 °(Figure 3).…”

Section: Report Of the Casementioning

confidence: 99%

Tibial Condyle Valgus Osteotomy for Ipsilateral Knee Osteoarthritis after Hip Arthrodesis

Fukuhara

Inoue

Nakagawa

et al. 2021

Case Reports in Orthopedics

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We report a case of tibial condylar valgus osteotomy (TCVO) for ipsilateral knee osteoarthritis (OA) after hip arthrodesis. A 58-year-old woman developed right purulent hip arthritis at one month of age and underwent right hip fusion at 16 years old. She visited our department at the age of 57 because her right knee joint pain worsened. The range of motion for her right knee was 80° and -5° of flexion and extension, respectively, and she experienced medial weight-bearing pain. A plain X-ray image showed that the right knee joint had end-stage knee OA with a bone defect inside the tibia, and the tibial plateau shape was the pagoda type. There was a marked instability in her right knee with a valgus of 9° and varus of 7° on stress photography. She underwent TCVO on her right knee and was allowed full load four weeks after surgery. Computed tomography imaging showed bone union nine months after surgery. Two years after the operation, there was no correction loss, and she could walk independently without pain. In general, total knee arthroplasty (TKA) is indicated for end-stage knee OA; however, there are problems, such as early loosening due to the increased mechanical load on the knee after hip OA. In this case, since a good course was obtained, TCVO is considered a treatment option for terminal knee OA after hip arthrodesis.

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Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Cited by 26 publications

References 54 publications

Salvage of severe knee osteoarthritis: efficacy of tibial condylar valgus osteotomy versus open wedge high tibial osteotomy

Salvage of severe knee osteoarthritis: efficacy of tibial condylar valgus osteotomy versus open wedge high tibial osteotomy

Reliability of Preoperative Planning Method That Considers Latent Medial Joint Laxity in Medial Open-Wedge Proximal Tibial Osteotomy

Tibial Condyle Valgus Osteotomy for Ipsilateral Knee Osteoarthritis after Hip Arthrodesis

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