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Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning

Ken Kumagai|Shuntaro Nejima|Shunsuke Yamada|Masaichi Sotozawa|Yutaka Inaba
대한슬관절학회 (Korean Knee Society)|2023.12|Knee Surgery and Related Research|제35권 |pp. 24-24|DOI 10.1186/s43019-023-00198-y

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초록

To evaluate the expected postoperative total leg length change using preoperative radiographs during surgical planning of four different methods of double level osteotomy (DLO).This study included 34 patients (44 knees) who underwent DLO for varus knee osteoarthritis. Surgical planning was performed so that the postoperative weight bearing line ratio was 62.5%. In DLO, lateral closed or medial open wedge distal femoral osteotomy (LCWDFO, MOWDFO) was performed so that the postoperative mechanical lateral distal femoral angle was 85°, and residual deformity was corrected with medial open or lateral closed wedge high tibial osteotomy (MOWHTO, LCWHTO). Pre- and surgical planning X-rays in the one-leg standing position were compared to assess the change in leg length, and the factors affecting it, in the various surgical groups. The proportion of cases in which Δ total leg length was greater than 6 mm (symptomatic change) was investigated.The mean postoperative total leg length increased significantly with LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, while it decreased with LCWDFO + LCWHTO. The proportion of cases with a postoperative total leg length change > 6 mm was 72.7%, 2.3%, 100%, and 6.8% in LCWDFO + MOWHTO, LCWDFO + LCWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, respectively. In addition, the preoperative hip-knee-ankle angle correlated negatively with the postoperative total leg length change in LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, but not in LCWDFO + LCWHTO.MOWDFO + MOWHTO had the largest postoperative leg length change and MOWDFO + LCWHTO had the smallest. Symptomatic leg length change (> 6 mm) should be considered in MOWDFO + MOWHTO and LCWDFO + MOWHTO.

Abstract

To evaluate the expected postoperative total leg length change using preoperative radiographs during surgical planning of four different methods of double level osteotomy (DLO).This study included 34 patients (44 knees) who underwent DLO for varus knee osteoarthritis. Surgical planning was performed so that the postoperative weight bearing line ratio was 62.5%. In DLO, lateral closed or medial open wedge distal femoral osteotomy (LCWDFO, MOWDFO) was performed so that the postoperative mechanical lateral distal femoral angle was 85°, and residual deformity was corrected with medial open or lateral closed wedge high tibial osteotomy (MOWHTO, LCWHTO). Pre- and surgical planning X-rays in the one-leg standing position were compared to assess the change in leg length, and the factors affecting it, in the various surgical groups. The proportion of cases in which Δ total leg length was greater than 6 mm (symptomatic change) was investigated.The mean postoperative total leg length increased significantly with LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, while it decreased with LCWDFO + LCWHTO. The proportion of cases with a postoperative total leg length change > 6 mm was 72.7%, 2.3%, 100%, and 6.8% in LCWDFO + MOWHTO, LCWDFO + LCWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, respectively. In addition, the preoperative hip-knee-ankle angle correlated negatively with the postoperative total leg length change in LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, but not in LCWDFO + LCWHTO.MOWDFO + MOWHTO had the largest postoperative leg length change and MOWDFO + LCWHTO had the smallest. Symptomatic leg length change (> 6 mm) should be considered in MOWDFO + MOWHTO and LCWDFO + MOWHTO.

참고문헌 (30)

  1. Lobenhoffer P, "Improvements in surgical technique of valgus high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 11(3), pp.132~138 (2003)
  2. Staubli AE, "TomoFix : a new LCP-concept for open wedge osteotomy of the medial proximal tibia–early results in 92 cases", Injury, 34, pp.B55~62 (2003)
  3. Schröter S, "Development of the double level osteotomy in severe varus osteoarthritis showed good outcome by preventing oblique joint line", Arch Orthop Trauma Surg, 139(4), pp.519~527 (2019)
  4. Nakayama H, "Physiologic knee joint alignment and orientation can be restored by the minimally invasive double level osteotomy for osteoarthritic knees with severe varus deformity", Knee Surg Sports Traumatol Arthrosc, 28(3), pp.742~750 (2020)
  5. Akamatsu Y, "Joint line obliquity was maintained after double-level osteotomy, but was increased after open-wedge high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 30(2), pp.688~697 (2022)
  6. Nakayama H, "Large correction in opening wedge high tibial osteotomy with resultant joint-line obliquity induces excessive shear stress on the articular cartilage", Knee Surg Sports Traumatol Arthrosc, 26(6), pp.1873~1878 (2018)
  7. Akamatsu Y, "Effect of increased coronal inclination of the tibial plateau after opening-wedge high tibial osteotomy", Arthroscopy, 34(7), pp.2158~2169 (2018)
  8. Schuster P, "Ten-year results of medial openwedge high tibial osteotomy and chondral resurfacing in severe medial osteoarthritis and varus malalignment", Am J Sports Med, 46(6), pp.1362~1370 (2018)
  9. Saito T, "Five-to ten-year outcome following medial opening-wedge high tibial osteotomy with rigid plate fixation in combination with an artificial bone substitute", J Bone Joint Surg, 96B(3), pp.339~344 (2014)
  10. Spahn G, "Complications in high tibial(medial opening wedge)osteotomy", Arch Orthop Trauma Surg, 124(10), pp.649~653 (2004)
  11. Miller BS, "Complications after medial opening wedge high tibial osteotomy", Arthroscopy, 25(6), pp.639~646 (2009)
  12. Song EK, "The complications of high tibial osteotomy : closing-versus opening-wedge methods", J Bone Joint Surg Br, 92(9), pp.1245~1252 (2010)
  13. McCaw ST, "Biomechanical implications of mild leg length inequality", Br J Sports Med, 25(1), pp.10~13 (1991)
  14. Gurney B, "Leg length discrepancy", Gait Posture, 15(2), pp.195~206 (2002)
  15. Rannisto S, "Leg-length discrepancy is associated with low back pain among those who must stand while working", BMC Musculoskelet Disord, 16, pp.110~ (2015)
  16. Iseki T, "Double-level osteotomy for severe varus osteoarthritic knees can prevent change in leg length and restore physiological joint geometry", Knee, 31, pp.136~143 (2021)
  17. Magnussen RA, "The effect of medial opening and lateral closing high tibial osteotomy on leg length", Am J Sports Med, 39(9), pp.1900~1905 (2011)
  18. Bae DK, "Change in limb length after high tibial osteotomy using computer-assisted surgery : a comparative study of closed-and open-wedge osteotomies", Knee Surg Sports Traumatol Arthrosc, 21(1), pp.120~126 (2013)
  19. Kim JI, "Lower limb length discrepancy after high tibial osteotomy : prospective randomized controlled trial of lateral closing versus medial opening wedge osteotomy", Am J Sports Med, 44(12), pp.3095~3102 (2016)
  20. Nerhus TK, "Radiological outcomes in a randomized trial comparing opening wedge and closing wedge techniques of high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 25(3), pp.910~917 (2017)
  21. Paley D, "Deformity planning for frontal and sagittal plane corrective osteotomies", Orthop Clin North Am, 25(3), pp.425~465 (1994)
  22. Han SB, "A"safe zone"in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture", Knee Surg Sports Traumatol Arthrosc, 21(1), pp.90~95 (2013)
  23. Takeuchi R, "A novel closed-wedge high tibial osteotomy procedure to treat osteoarthritis of the knee : hybrid technique and rehabilitation measures", Arthrosc Tech, 3(4), pp.e431~437 (2014)
  24. Ishimatsu T, "Hybrid closed wedge high tibial osteotomy improves patellofemoral joint congruity compared with open wedge high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 27(4), pp.1299~1309 (2019)
  25. Lee SS, "Predictive factors for and detection of lateral hinge fractures following open wedge high tibial osteotomy : plain radiography versus computed tomography", Arthroscopy, 34(11), pp.3073~3079 (2018)
  26. Goshima K, "Large opening gaps, unstable hinge fractures, and osteotomy line below the safe zone cause delayed bone healing after open-wedge high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 27(4), pp.1291~1298 (2019)
  27. Tanaka T, "Deterioration of patellofemoral cartilage status after medial open-wedge high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 27(4), pp.1347~1354 (2019)
  28. Ogawa H, "Effects of lateral opening wedge and medial closing wedge distal femoral osteotomies on axial load stability", Knee, 27(3), pp.760~766 (2020)
  29. Santoso MB, "Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review", J Orthop Surg Res, 12(1), pp.50~ (2017)
  30. Cao Z, "Unicompartmental knee arthroplasty vs high tibial osteotomy for knee osteoarthritis : a systematic review and meta-analysis", J Arthroplasty, 33(3), pp.952~959 (2018)

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