NDLI: Estimation of the proper gap ratio using preoperative radiography for posterior tibial slope maintenance in biplanar open wedge high tibial osteotomy

Content Provider	Springer Nature : BioMed Central
Author	Yoon, Jung-Ro Koh, Young Yoon Lee, Seung Hoon
Abstract	Background This study aimed to estimate the ratio of the anterior and posterior gaps before surgery that can minimize the posterior tibial slope (PTS) change through preoperative radiography, and to confirm whether the use of the block helps maintain the PTS during open wedge high tibial osteotomy (OWHTO). Methods Patients who underwent OWHTO between 2015 and 2018 were included. To measure optimal anterior gap (AG) and posterior gap (PG) ratio, hinge to medial tibial tuberosity length (HTL), total osteotomy length (TOL), and PTS were measured using knee AP X-ray. Real AG and PG were measured using postoperative knee computed tomography. Use of the block was also confirmed. Results Total 107 knees (95 patients) were included. The average ratio between HTL and TOL was 70.9%. The average ratio AG: PG was 72.9%. PTS increased significantly from 10.2° to 11.2° postoperatively (p = 0.006). When the difference in HTL: TOL and AG: PG, and the amount of PTS change were analyzed using linear regression, there was a statistically significant correlation (correlation coefficient: − 25.9; p < 0.001). There was no difference in AG: PG according to the use of the block (p = 0.882). Conclusion In OWHTO, PTS change can be minimized by estimating the ratio of the AG and PG using radiographs, and is was approximately 70%. If the ratio is increased by 10% from the predicted value, the PTS increases by approximately 2.6°. Using a block during OWHTO did not have a considerable advantage in terms of PTS maintenance compared to the group not using a block. Level of evidence Level IV.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-023-03712-w.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-023-03712-w
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2023-03-20
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics High tibial osteotomy Posterior tibial slope Block
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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