Hybrid Lateral Closed-Wedge High Tibial Osteotomy Showed Similar Accuracy in Angular Correction and Reduction of Posterior Tibial Slope Compared to Opening-Wedge High Tibial Osteotomy: A Correction Angle Matched Cohort Study |
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| Institution: | 1. Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea;2. Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea;3. Department of Orthopedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea;1. Department of Orthopedics, Orthopedic Research Institute, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China;2. Department of Orthopedic Surgery, Peking Union Medical College Hospital, Beijing, China;3. Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China;4. School of Life Sciences, Tsinghua University, Beijing, China;5. Institute of Biomedical and Health Engineering (iBHE), Tsinghua Shenzhen International Graduate School, Shenzhen, China;6. Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China;7. Longwood Valley, Beijing, China;8. School of Medicine, Tsinghua University, Beijing, China;1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota;2. Mayo Clinic Alix School of Medicine, Rochester, Minnesota;1. Department of Orthopaedic Surgery, George Washington University Hospital, Washington, District of Columbia;2. Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland;1. Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China;2. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China;3. Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital, Central South University, Changsha, Hunan Province, China;4. Hunan Key Laboratary of Aging Biology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China;5. Department of Orthopedics, Peking University Third Hospital, Beijing, China |
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| Abstract: | BackgroundWe aimed to compare the accuracy of applied correction angle between hybrid lateral closed wedge high tibial osteotomy (hybrid HTO) and medial open wedge high tibial osteotomy (OWHTO), and verify previous reports on hybrid HTO by matching correction angle between groups. Change in various radiological parameters including union rate were also compared.MethodsA total of 50 OWHTO patients were selected for 2:1 propensity matching with 25 hybrid HTO patients. Rate of correction error was calculated by dividing the difference between the change in medial proximal tibial angle and preoperatively planned correction angle (PRD) by planned correction angle. Accuracy of angular correction was assessed using PRD and correction error rates. Hip-knee-ankle axis, mechanical lateral distal femoral angle, medial proximal tibial angle, joint line convergence angle, and length of the entire lower limb and tibia were measured. The Caton-Deschamps index (CDI) was used to assess change in patellar height. Serial postoperative radiographic analysis was performed to assess the union rate.ResultsThe discrepancy between planned correction angle and real correction angle was 0.8 ± 2.3° in hybrid HTO and 1.1 ± 3.4° in OWHTO (P > .05), and the rate of error in osteotomy was similar between the groups approximately 6%. Postoperatively, posterior tibial slope (PTS) (P < .001), tibia length, and CDI (P < .001) were significantly different between groups. The amount of change in PTS (P < .001), tibia length in hybrid HTO (P < .001), and CDI (P < .001) were significantly different between groups. Union rate of osteotomy site was significantly faster in hybrid HTO than in OWHTO (P < .001).ConclusionHybrid HTO showed similar accuracy in angular correction compared to correction angle-matched OWHTO. Reduction in PTS, tibial shortening, maintained patellar height relative to the proximal tibia, and faster osteotomy site union were also confirmed in hybrid HTO. |
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| Keywords: | knee osteotomy arthritis alignment correction |
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