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Assessment of valgus laxity after release of the medial structure in medial open-wedge high tibial osteotomy : an in vivo biomechanical study using quantitative valgus stress radiography

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Title: Assessment of valgus laxity after release of the medial structure in medial open-wedge high tibial osteotomy : an in vivo biomechanical study using quantitative valgus stress radiography
Authors: Sato, Dai Browse this author
Kondo, Eiji Browse this author →KAKEN DB
Yabuuchi, Koji Browse this author
Onodera, Jun Browse this author →KAKEN DB
Onodera, Tomohiro Browse this author →KAKEN DB
Yagi, Tomonori Browse this author
Sakamoto, Keita Browse this author
Takasawa, Akira Browse this author →KAKEN DB
Iwasaki, Norimasa Browse this author →KAKEN DB
Yasuda, Kazunori Browse this author →KAKEN DB
Keywords: Medial open-wedge high tibial osteotomy
Superficial layer of the medial collateral ligament
Valgus instability
Valgus stress test
Issue Date: 27-Oct-2019
Publisher: BioMed Central
Journal Title: BMC musculoskeletal disorders
Volume: 20
Issue: 1
Start Page: 481
Publisher DOI: 10.1186/s12891-019-2859-7
Abstract: Background: To perform medial open-wedge high tibial osteotomy (OWHTO), surgeons expose the medial-proximal tibia by releasing or cutting the superficial layer of the medial collateral ligament (sMCL). Biomechanically, the sMCL provides primary restraint against valgus forces. Therefore, any release of the sMCL can cause valgus instability of the knee joint. The purpose of this study was to assess valgus laxity after release of the medial structure of the knee during OWHTO. Methods: Between 2009 and 2015, 84 consecutive patients (93 knees) who underwent OWHTO using a locking plate were enrolled in this study. All patients underwent radiological examinations before surgery, during surgery, 1 year after surgery, and after plate removal to objectively assess valgus laxity. The medial joint space (MJS) and the joint line convergence angle (JLCA) of the knee were evaluated using quantitative valgus stress radiography. Clinical evaluation was performed 2 years after surgery. Results: The mean functional knee score improved significantly, from 65.5 to 91.1 points (p < 0.0001). The mechanical axis percentage shifted to pass through a point 69.7% lateral from the medial edge of the tibial plateau. The MJS and JLCA increased significantly during OWHTO surgery (11.0 mm, 7.4 degrees, p < 0.0001). However, no significant differences were noted in the MJS and JLCA among preoperative, 1-year postoperative periods and after plate removal. Conclusion: Valgus laxity was significantly greater after release of the sMCL. However, no significant differences were noted in valgus laxity in preoperative, 1-year postoperative periods and after plate removal. Complete release of the sMCL did not cause postoperative valgus laxity after OWHTO surgery.
Rights: https://creativecommons.org/licenses/by/4.0/
Type: article
URI: http://hdl.handle.net/2115/76508
Appears in Collections:国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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