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논문 기본 정보

자료유형
학술저널
저자정보
Na Young Gon (Department of Orthopedic Surgery CM Hospital) Lee Beom Koo (Department of Orthopedic Surgery Gachon University Gil Medical Center) Choi Ji Uk (Department of Orthopedic Surgery Gachon University Gil Medical Center) Lee Byung Hoon (Department of Orthopedic Surgery Gachon University Gil Medical Center) 심재앙 (가천대학교)
저널정보
대한슬관절학회 Knee Surgery and Related Research Knee Surgery and Related Research 제33권
발행연도
2021.1
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4 - 4 (1page)

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The alignment correction after high tibial osteotomy (HTO) is made both by bony correction and soft-tissue correction around the knee. Change of the joint-line convergence angle (JLCA) represents the soft-tissue correction after HTO, which is the angle made by a tangential line between the femoral condyles and the tibial plateau. We described the patterns of JLCA change and related factors after HTO and investigated the appropriate preoperative planning method.Eighty patients who underwent HTO between 2013 and 2016 were included for this retrospective study. Standing, whole-limb radiograph, supine knee anteroposterior (AP) and lateral were measured on the preoperative and postoperative radiographs. The patterns of JLCA changes and related factors were analyzed. JLCA decreased by a mean of 0.9°?±?1.2° ( P <?0.001) after HTO. Sixteen patients (20%, group II) showed a greater JLCA decrease ≥?2°, while 64 (80%, group I) patients remained in a narrow range of JLCA change <?2°. Group II showed more varus deformity (varus 8.1° vs. varus 4.7° in the mechanical femorotibial angle, P <?0.001), greater JLCA on standing (4.9° vs. 2.1°, P <?0.001), and the difference of JLCA in the standing and supine positions (2.8° vs. 0.7°, P <?0.001) preoperatively compared to group I. The risk of a greater JLCA decrease ≥?2° was associated with greater preoperative JLCA in the standing position and the difference between the JLCA in the standing and supine positions. Postoperative JLCA correlated better with preoperative JLCA in the supine position than those in the standing position. A preoperative JLCA ≥?4° or the difference of preoperative JLCA in the standing and supine positions ≥?1.7° was the cut-off value to predict a large JLCA decrease ≥?2° after HTO in the receiver operating characteristic (ROC) curve analysis. Surgeons should consider the effect of the JLCA change during the preoperative planning and intraoperative procedure to avoid unintended overcorrection.

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