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Preoperative joint line convergence angle correction is a key factor in optimising accuracy in varus knee correction osteotomy

Standard

Preoperative joint line convergence angle correction is a key factor in optimising accuracy in varus knee correction osteotomy. / Behrendt, P; Akoto, R; Bartels, I; Thürig, G; Fahlbusch, H; Korthaus, A; Dalos, D; Hoffmann, M; Frosch, K-H; Krause, M.

In: KNEE SURG SPORT TR A, Vol. 31, No. 4, 04.2023, p. 1583-1592.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Behrendt, P, Akoto, R, Bartels, I, Thürig, G, Fahlbusch, H, Korthaus, A, Dalos, D, Hoffmann, M, Frosch, K-H & Krause, M 2023, 'Preoperative joint line convergence angle correction is a key factor in optimising accuracy in varus knee correction osteotomy', KNEE SURG SPORT TR A, vol. 31, no. 4, pp. 1583-1592. https://doi.org/10.1007/s00167-022-07092-2

APA

Behrendt, P., Akoto, R., Bartels, I., Thürig, G., Fahlbusch, H., Korthaus, A., Dalos, D., Hoffmann, M., Frosch, K-H., & Krause, M. (2023). Preoperative joint line convergence angle correction is a key factor in optimising accuracy in varus knee correction osteotomy. KNEE SURG SPORT TR A, 31(4), 1583-1592. https://doi.org/10.1007/s00167-022-07092-2

Vancouver

Behrendt P, Akoto R, Bartels I, Thürig G, Fahlbusch H, Korthaus A et al. Preoperative joint line convergence angle correction is a key factor in optimising accuracy in varus knee correction osteotomy. KNEE SURG SPORT TR A. 2023 Apr;31(4):1583-1592. https://doi.org/10.1007/s00167-022-07092-2

Bibtex

@article{b1b0e9e6b9684b7399d7faaf396935e2,
title = "Preoperative joint line convergence angle correction is a key factor in optimising accuracy in varus knee correction osteotomy",
abstract = "PURPOSE: This study aimed to identify and prevent preoperative factors that can be influenced in preoperative planning to reduce postoperative malcorrections.METHODS: The method used in this study was a retrospective two-centre analysis of 78 pre and postoperative fully weight-bearing radiographs of patients who underwent valgus osteotomy correction due to symptomatic medial compartment osteoarthritis. A computer software (TraumaCad{\textregistered}) was used to aim for an intersection point of the mechanical tibiofemoral axis (mTFA) with the tibia plateau at 55-60% (medial = 0%, lateral = 100%). Postoperative divergence ± 5% of this point was defined as over- and undercorrection. Preoperative joint geometry factors were correlated with postoperative malcorrection. Planning was conducted using the established method described by Miniaci (Group A) and with additional correction of the joint line convergence angle (JLCA) using the formula JLCA-2/2 (Group B). Additionally, in a small clinical case series, planning was conducted with JLCA correction. Statistical analysis was performed using (multiple) linear regression analysis and analysis of variance (ANOVA) with p < 0.05 considered significant.RESULTS: In 78 analysed cases, postoperative malcorrection was detected in 37.2% (5.1% undercorrection, 32.1% overcorrection). Linear regression analysis revealed preoperative body mass index (BMI, p = 0.04), JLCA (p = 0.0001), and osteotomy level divergence (p = 0.0005) as factors correlated with overcorrection. In a multiple regression analysis, JLCA and osteotomy level divergence remained significant factors. Preoperative JLCA correction reduced the planned osteotomy gap (A 9.7 ± 2.8 mm vs B 8.3 ± 2.4 mm; p > 0.05) and postoperative medial proximal tibial angle (MPTA: A 94.3 ± 2.1° vs B 92.3 ± 1.5°; p < .05) in patients with preoperative JLCA ≥ 4°. The results were validated using a virtual postoperative correction of cases with overcorrection. A case series (n = 8) with a preoperative JLCA > 4 revealed a postoperative accuracy using the JLCA correction of 3.4 ± 1.9%.CONCLUSION: Preoperative JLCA ≥ 4° and tibial osteotomy level divergence were identified as risk factors for postoperative overcorrection. Preoperative JLCA correction using the formula JLCA-2/2 is proposed to better control ideal postoperative correction and reduce MPTA. The intraoperatively realised osteotomy level should be precisely in accordance with preoperative planning.LEVEL OF EVIDENCE: III, cross-sectional study.",
author = "P Behrendt and R Akoto and I Bartels and G Th{\"u}rig and H Fahlbusch and A Korthaus and D Dalos and M Hoffmann and K-H Frosch and M Krause",
note = "{\textcopyright} 2022. The Author(s).",
year = "2023",
month = apr,
doi = "10.1007/s00167-022-07092-2",
language = "English",
volume = "31",
pages = "1583--1592",
journal = "KNEE SURG SPORT TR A",
issn = "0942-2056",
publisher = "Springer",
number = "4",

}

RIS

TY - JOUR

T1 - Preoperative joint line convergence angle correction is a key factor in optimising accuracy in varus knee correction osteotomy

AU - Behrendt, P

AU - Akoto, R

AU - Bartels, I

AU - Thürig, G

AU - Fahlbusch, H

AU - Korthaus, A

AU - Dalos, D

AU - Hoffmann, M

AU - Frosch, K-H

AU - Krause, M

N1 - © 2022. The Author(s).

PY - 2023/4

Y1 - 2023/4

N2 - PURPOSE: This study aimed to identify and prevent preoperative factors that can be influenced in preoperative planning to reduce postoperative malcorrections.METHODS: The method used in this study was a retrospective two-centre analysis of 78 pre and postoperative fully weight-bearing radiographs of patients who underwent valgus osteotomy correction due to symptomatic medial compartment osteoarthritis. A computer software (TraumaCad®) was used to aim for an intersection point of the mechanical tibiofemoral axis (mTFA) with the tibia plateau at 55-60% (medial = 0%, lateral = 100%). Postoperative divergence ± 5% of this point was defined as over- and undercorrection. Preoperative joint geometry factors were correlated with postoperative malcorrection. Planning was conducted using the established method described by Miniaci (Group A) and with additional correction of the joint line convergence angle (JLCA) using the formula JLCA-2/2 (Group B). Additionally, in a small clinical case series, planning was conducted with JLCA correction. Statistical analysis was performed using (multiple) linear regression analysis and analysis of variance (ANOVA) with p < 0.05 considered significant.RESULTS: In 78 analysed cases, postoperative malcorrection was detected in 37.2% (5.1% undercorrection, 32.1% overcorrection). Linear regression analysis revealed preoperative body mass index (BMI, p = 0.04), JLCA (p = 0.0001), and osteotomy level divergence (p = 0.0005) as factors correlated with overcorrection. In a multiple regression analysis, JLCA and osteotomy level divergence remained significant factors. Preoperative JLCA correction reduced the planned osteotomy gap (A 9.7 ± 2.8 mm vs B 8.3 ± 2.4 mm; p > 0.05) and postoperative medial proximal tibial angle (MPTA: A 94.3 ± 2.1° vs B 92.3 ± 1.5°; p < .05) in patients with preoperative JLCA ≥ 4°. The results were validated using a virtual postoperative correction of cases with overcorrection. A case series (n = 8) with a preoperative JLCA > 4 revealed a postoperative accuracy using the JLCA correction of 3.4 ± 1.9%.CONCLUSION: Preoperative JLCA ≥ 4° and tibial osteotomy level divergence were identified as risk factors for postoperative overcorrection. Preoperative JLCA correction using the formula JLCA-2/2 is proposed to better control ideal postoperative correction and reduce MPTA. The intraoperatively realised osteotomy level should be precisely in accordance with preoperative planning.LEVEL OF EVIDENCE: III, cross-sectional study.

AB - PURPOSE: This study aimed to identify and prevent preoperative factors that can be influenced in preoperative planning to reduce postoperative malcorrections.METHODS: The method used in this study was a retrospective two-centre analysis of 78 pre and postoperative fully weight-bearing radiographs of patients who underwent valgus osteotomy correction due to symptomatic medial compartment osteoarthritis. A computer software (TraumaCad®) was used to aim for an intersection point of the mechanical tibiofemoral axis (mTFA) with the tibia plateau at 55-60% (medial = 0%, lateral = 100%). Postoperative divergence ± 5% of this point was defined as over- and undercorrection. Preoperative joint geometry factors were correlated with postoperative malcorrection. Planning was conducted using the established method described by Miniaci (Group A) and with additional correction of the joint line convergence angle (JLCA) using the formula JLCA-2/2 (Group B). Additionally, in a small clinical case series, planning was conducted with JLCA correction. Statistical analysis was performed using (multiple) linear regression analysis and analysis of variance (ANOVA) with p < 0.05 considered significant.RESULTS: In 78 analysed cases, postoperative malcorrection was detected in 37.2% (5.1% undercorrection, 32.1% overcorrection). Linear regression analysis revealed preoperative body mass index (BMI, p = 0.04), JLCA (p = 0.0001), and osteotomy level divergence (p = 0.0005) as factors correlated with overcorrection. In a multiple regression analysis, JLCA and osteotomy level divergence remained significant factors. Preoperative JLCA correction reduced the planned osteotomy gap (A 9.7 ± 2.8 mm vs B 8.3 ± 2.4 mm; p > 0.05) and postoperative medial proximal tibial angle (MPTA: A 94.3 ± 2.1° vs B 92.3 ± 1.5°; p < .05) in patients with preoperative JLCA ≥ 4°. The results were validated using a virtual postoperative correction of cases with overcorrection. A case series (n = 8) with a preoperative JLCA > 4 revealed a postoperative accuracy using the JLCA correction of 3.4 ± 1.9%.CONCLUSION: Preoperative JLCA ≥ 4° and tibial osteotomy level divergence were identified as risk factors for postoperative overcorrection. Preoperative JLCA correction using the formula JLCA-2/2 is proposed to better control ideal postoperative correction and reduce MPTA. The intraoperatively realised osteotomy level should be precisely in accordance with preoperative planning.LEVEL OF EVIDENCE: III, cross-sectional study.

U2 - 10.1007/s00167-022-07092-2

DO - 10.1007/s00167-022-07092-2

M3 - SCORING: Journal article

C2 - 35994079

VL - 31

SP - 1583

EP - 1592

JO - KNEE SURG SPORT TR A

JF - KNEE SURG SPORT TR A

SN - 0942-2056

IS - 4

ER -