Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy

Abstract Background Posterior tibial slope (PTS) increases after medial open-wedge high tibial osteotomy (OWHTO) is challenging for patients. This study aims to determine whether use of a suspended and straightened knee joint position during the fixing of steel plates can prevent an increase in the...

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Autores principales:	Wenru Ma, Zengshuai Han, Shengnan Sun, Jinli Chen, Yi Zhang, Tengbo Yu
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Knee osteoarthritis Open-wedge high tibial osteotomy Posterior tibial slope angle Suspended and straightened knee joint position Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/b280d310fc4c4b579462369ca15b65d0
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spelling	oai:doaj.org-article:b280d310fc4c4b579462369ca15b65d02021-11-21T12:29:53ZUse of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy10.1186/s13018-021-02834-31749-799Xhttps://doaj.org/article/b280d310fc4c4b579462369ca15b65d02021-11-01T00:00:00Zhttps://doi.org/10.1186/s13018-021-02834-3https://doaj.org/toc/1749-799XAbstract Background Posterior tibial slope (PTS) increases after medial open-wedge high tibial osteotomy (OWHTO) is challenging for patients. This study aims to determine whether use of a suspended and straightened knee joint position during the fixing of steel plates can prevent an increase in the PTS after OWHTO. Methods This study retrospectively analyzed 112 subjects (122 knees) [34 males, 78 females; mean age 59.1 ± 6.6 (range 48–76) years; mean body mass index 28.06 ± 3.61 kg/m2] who underwent OWHTO. A total of 78 knees that were suspended and extended by placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the suspended and straightened knee joint position (SSP) group, and 44 knees that were kept naturally straightened without placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the naturally straightened knee joint position (NSP) group. Patients were clinically assessed according to the visual analog pain scale (VAS), the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, the Knee Society Scores (KSS) knee and function scores, the Hospital for Special Surgery (HSS) knee scores and the Lysholm knee scores. Radiological assessment was performed according to the changes in the PTS between preoperation, 1-day postoperation, and the final follow-up periods. Ultimately, the difference in postoperative PTS changes between the two groups was statistically analyzed. The median follow-up period was 2.2 years (range 1.6–3.7 years). Results In the final follow-up period, significant improvements were observed in the clinical VAS scores, WOMAC scores, KSS knee and function scores, HSS scores and the Lysholm knee scores in both groups (P < 0.001), and no difference was found between the two groups. Radiological assessment showed that there was no statistical difference in the preoperative PTS between the two groups. The 1-day postoperative PTS and the most recent follow-up PTS were significantly greater than the preoperative PTS in the NSP group (t = − 3.213, − 6.406, all P < 0.001), but no significant increase was seen in the SSP group (P > 0.05). The increase in PTS in the NSP group was significantly greater than that in the SSP group at the 1-day postoperative (t = 2.243, P = 0.030) and final follow-up periods (t = 6.501, P < 0.001). Conclusions For OWHTO, the use of a suspended and straightened knee joint position rather than a naturally straightened knee joint position during the fixing of steel plates could effectively prevent the increase in postoperative PTS. Level of Evidence: Retrospective Study Level III.Wenru MaZengshuai HanShengnan SunJinli ChenYi ZhangTengbo YuBMCarticleKnee osteoarthritisOpen-wedge high tibial osteotomyPosterior tibial slope angleSuspended and straightened knee joint positionOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Knee osteoarthritis Open-wedge high tibial osteotomy Posterior tibial slope angle Suspended and straightened knee joint position Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	Knee osteoarthritis Open-wedge high tibial osteotomy Posterior tibial slope angle Suspended and straightened knee joint position Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 Wenru Ma Zengshuai Han Shengnan Sun Jinli Chen Yi Zhang Tengbo Yu Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy
description	Abstract Background Posterior tibial slope (PTS) increases after medial open-wedge high tibial osteotomy (OWHTO) is challenging for patients. This study aims to determine whether use of a suspended and straightened knee joint position during the fixing of steel plates can prevent an increase in the PTS after OWHTO. Methods This study retrospectively analyzed 112 subjects (122 knees) [34 males, 78 females; mean age 59.1 ± 6.6 (range 48–76) years; mean body mass index 28.06 ± 3.61 kg/m2] who underwent OWHTO. A total of 78 knees that were suspended and extended by placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the suspended and straightened knee joint position (SSP) group, and 44 knees that were kept naturally straightened without placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the naturally straightened knee joint position (NSP) group. Patients were clinically assessed according to the visual analog pain scale (VAS), the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, the Knee Society Scores (KSS) knee and function scores, the Hospital for Special Surgery (HSS) knee scores and the Lysholm knee scores. Radiological assessment was performed according to the changes in the PTS between preoperation, 1-day postoperation, and the final follow-up periods. Ultimately, the difference in postoperative PTS changes between the two groups was statistically analyzed. The median follow-up period was 2.2 years (range 1.6–3.7 years). Results In the final follow-up period, significant improvements were observed in the clinical VAS scores, WOMAC scores, KSS knee and function scores, HSS scores and the Lysholm knee scores in both groups (P < 0.001), and no difference was found between the two groups. Radiological assessment showed that there was no statistical difference in the preoperative PTS between the two groups. The 1-day postoperative PTS and the most recent follow-up PTS were significantly greater than the preoperative PTS in the NSP group (t = − 3.213, − 6.406, all P < 0.001), but no significant increase was seen in the SSP group (P > 0.05). The increase in PTS in the NSP group was significantly greater than that in the SSP group at the 1-day postoperative (t = 2.243, P = 0.030) and final follow-up periods (t = 6.501, P < 0.001). Conclusions For OWHTO, the use of a suspended and straightened knee joint position rather than a naturally straightened knee joint position during the fixing of steel plates could effectively prevent the increase in postoperative PTS. Level of Evidence: Retrospective Study Level III.
format	article
author	Wenru Ma Zengshuai Han Shengnan Sun Jinli Chen Yi Zhang Tengbo Yu
author_facet	Wenru Ma Zengshuai Han Shengnan Sun Jinli Chen Yi Zhang Tengbo Yu
author_sort	Wenru Ma
title	Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy
title_short	Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy
title_full	Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy
title_fullStr	Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy
title_full_unstemmed	Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy
title_sort	use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b280d310fc4c4b579462369ca15b65d0
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Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy

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