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Changes in joint space width over time and risk factors for deterioration of joint space width after medial opening-wedge high tibial osteotomy

  • Orthopaedic Surgery
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Abstract

Purpose

The purpose of this study was to evaluate the changes in joint space width (JSW) over time after medial opening-wedge high tibial osteotomy (MOWHTO) and identify risk factors for deterioration of JSW using anteroposterior (AP) and Rosenberg views.

Methods

We retrospectively analyzed changes in JSW of 104 MOWHTO patients whose preoperative osteoarthritis (OA) grade was K-L grade 3 or less on AP and Rosenberg views. Serial changes in JSW were assessed from preoperatively to at least 3 years postoperatively. Patients were divided into two groups according to JSW change patterns on each of AP and Rosenberg views: non-deterioration group had either unchanged or increased JSW, and deterioration group had decreased JSW. Clinical outcomes were compared using Western Ontario and McMaster Universities OA Index (WOMAC) score between groups. Multivariate logistic regression analysis was performed to identify risk factors for deterioration of JSW.

Results

JSW on average for all patients increased 0.5 mm and 0.8 mm on AP and Rosenberg views, respectively (p < 0.05). Non-deterioration group showed significant improvement based on patient-reported outcomes (WOMAC) than deterioration group (all p < 0.05). Undercorrection was an independent risk factor for failure to achieve maintained or increased JSW on both AP (OR 6.885, 95% CI 1.976–23.986, p = 0.002) and Rosenberg (OR 12.756, 95% CI 2.952–55.129, p = 0.001) views.

Conclusion

JSW increased gradually and continuously on standing AP and Rosenberg views until postoperative 3 years after MOWHTO. Deterioration of JSW following MOWHTO was closely related to the undercorrection and affected clinical outcomes.

Level of evidence

Level III, case control study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Man Soo Kim, Keun Young Choi, Bo Seoung Kim & Yong In

  2. Department of Orthopaedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil Ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea

    In Jun Koh

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All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee, the 1964 Helsinki Declaration, and its later amendments or comparable ethical standards. This study was approved by IRB of Seoul St. Mary’s Hospital, the Catholic University of Korea (Study No.: KC20RISI0694). This study obtained institutional review board approval from the Institutional Review Board (IRB) of Seoul St. Mary’s Hospital (KC20RISI0694) and informed written consent for participation in the study was obtained.

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Kim, M.S., Koh, I.J., Choi, K.Y. et al. Changes in joint space width over time and risk factors for deterioration of joint space width after medial opening-wedge high tibial osteotomy. Arch Orthop Trauma Surg 142, 2513–2524 (2022). https://doi.org/10.1007/s00402-021-03876-2

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