The Department of Medicine, Yonsei University Graduate School, Seoul, Republic of Korea.
The Department of Orthopaedic Surgery, The Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, C.P.O. Box 8044, Seoul, 120-752, Republic of Korea.
Sci Rep. 2022 Nov 10;12(1):19254. doi: 10.1038/s41598-022-23412-5.
In performing medial open-wedge high tibial osteotomy, it is recommended not to alter the posterior tibial slope. However, it remains unclear whether the osteotomy inclination angle affects the posterior tibial slope in the sagittal plane. This study aimed to verify how anterior or posterior osteotomy inclination angle affects the tendency of change in the posterior tibial slope and to conduct quantitative analysis of the extent to which the posterior tibial slope changes according to the degree of the osteotomy inclination angle change in MOWHTO. Computed tomography images of 30 patients who underwent MOWHTO were collected. Three-dimensional models of preoperative original tibia were reconstructed, and virtual osteotomies were performed. The sagittal osteotomy inclination angles formed by the osteotomy line and the medial tibial plateau line were classified as positive in case of anteriorly inclined osteotomy and negative in case of posteriorly inclined osteotomy. Thirteen osteotomies were performed for each tibial model at intervals of 5° from - 30° to 30°. The posterior tibial slope was assessed, and the proportional relationship between the sagittal osteotomy inclination angle and the posterior tibial slope change was analyzed. The posterior tibial slope changed significantly after osteotomy (p < 0.001), except for the cases where the sagittal osteotomy inclination angles were 5°, 0°, and - 5°. Anteriorly and posteriorly inclined osteotomy caused increase and decrease in the posterior tibial slope, respectively. As the inclination angle increased by 1°, the posterior tibial slope increased by 0.079° in anterior inclination osteotomy, while in posterior inclination osteotomy, as the inclination angle decreased by 1°, the posterior tibial slope decreased by 0.067°. The osteotomy inclination angle in the sagittal plane significantly affected the posterior tibial slope. When there was an inclination angle occurred between the osteotomy line and the medial tibial plateau line in the sagittal plane, the posterior tibial slope changed after MOWHTO. The posterior tibial slope tended to increase in anteriorly inclined osteotomy and decrease in posteriorly inclined osteotomy. The change in the posterior tibial slope was proportionally related to the absolute value of the osteotomy inclination angle.
在进行内侧开放楔形胫骨高位截骨术时，建议不要改变胫骨后倾角。然而，截骨倾斜角度是否会影响矢状面胫骨后倾角尚不清楚。本研究旨在验证前或后截骨倾斜角度如何影响胫骨后倾角的变化趋势，并对 MOWHTO 中截骨倾斜角度变化程度对胫骨后倾角变化的程度进行定量分析。收集了 30 例接受 MOWHTO 的患者的计算机断层扫描图像。对术前原始胫骨进行三维模型重建，并进行虚拟截骨。将截骨线与内侧胫骨平台线形成的矢状面截骨倾斜角度分为前倾角（截骨线在胫骨平台线的前方）为正，后倾角（截骨线在胫骨平台线的后方）为负。对每个胫骨模型进行 13 次截骨，间隔 5°，从-30°到 30°。评估胫骨后倾角，并分析矢状面截骨倾斜角度与胫骨后倾角变化的比例关系。截骨后胫骨后倾角发生显著变化（p<0.001），除了矢状面截骨倾斜角度为 5°、0°和-5°的情况。前倾角和后倾角截骨分别导致胫骨后倾角增加和减少。当倾斜角度增加 1°时，前倾角截骨中胫骨后倾角增加 0.079°，而后倾角截骨中，当倾斜角度减小 1°时，胫骨后倾角减小 0.067°。矢状面的截骨倾斜角度显著影响胫骨后倾角。当矢状面截骨线与内侧胫骨平台线之间存在倾斜角度时，MOWHTO 后胫骨后倾角发生变化。前倾角截骨中胫骨后倾角趋于增加，后倾角截骨中胫骨后倾角趋于减少。胫骨后倾角的变化与截骨倾斜角度的绝对值成正比。
