Evidence map›Paper›PMID 26467810›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017

Radiological outcomes in a randomized trial comparing opening wedge and closing wedge techniques of high tibial osteotomy.

Tor Kjetil Nerhus, Arne Ekeland, Geir Solberg, Einar Andreas Sivertsen, Jan Erik Madsen, Stig Heir

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 8 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 8 syntheses or guidelines pooled it, 80 citations in OpenAlex.

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  5. Surgical interventions for symptomatic mild to moderate knee osteoarthritis.The Cochrane database of systematic reviews · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Tor Kjetil NerhusDepartment of Orthopedic Surgery, Martina Hansens Hospital, Box 823, 1306, Sandvika, Norway. kjnerhus@gmail.com.
Arne EkelandDepartment of Orthopedic Surgery, Martina Hansens Hospital, Box 823, 1306, Sandvika, Norway.
Geir SolbergDepartment of Orthopedic Surgery, Martina Hansens Hospital, Box 823, 1306, Sandvika, Norway.
Einar Andreas SivertsenDepartment of Orthopedic Surgery, Diakonhjemmet Hospital, Oslo, Norway.
Jan Erik MadsenDepartment of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
Stig HeirDepartment of Orthopedic Surgery, Martina Hansens Hospital, Box 823, 1306, Sandvika, Norway.
Martina Hansens Hospital · NODiakonhjemmet Hospital · NOOslo University Hospital · NOSandvik (Norway) · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of the present study was to examine changes in radiological variables in a prospective randomized study comparing opening wedge (OW) and closing wedge (CW) techniques of high tibial osteotomy (HTO). Our hypothesis was that there would be no differences in joint line angles or correction accuracy between the two groups, that patellar height would increase after CW HTO and decrease after OW HTO, and that leg length and posterior tibial slope would decrease after CW HTO and increase after OW HTO.

methodsRadiological data were collected from 70 patients participating in an ongoing prospective randomized clinical trial comparing OW and CW HTOs. Digital standing hip-knee-ankle (HKA) radiographs as well as lateral radiographs in 30° of flexion were obtained preoperatively and at 6 months for each patient. Joint line angles, HKA angle, leg length, Insall-Salvati index, Miura-Kawamura index and posterior tibial slope were measured using medical planning software. The complete preoperative radiological examinations of the first 50 patients were used in a study of intra- and inter-rater reliability of the measurements.

resultsThe mean posterior slope was reduced by 2.5° in CW HTO, whereas it remained unchanged in OW HTO (p < 0.001). Mean leg length decreased 5.7 mm in CW HTO and increased 3.1 mm in OW HTO (p < 0.001). Changes in joint line angles, patellar height indexes and the correction accuracy showed no significant differences comparing the two techniques. Frontal plane reliability measurement intra- and inter-rater intraclass correlation coefficient (ICC) varied from 0.81 to 0.99. Sagittal plane intra- and inter-rater ICC varied from 0.60 to 0.87. Posterior tibial slope intra- and inter-rater ICC showed the lowest values (0.70 and 0.60, respectively) corresponding to a smallest real difference of 4.5° and 5.5°, respectively.

conclusionsPosterior tibial slope and leg length changes were significantly different in CW compared to OW HTOs. We recommend that possible alterations in tibial slope and leg length are considered when the technique of HTO is to be chosen. Landmark-based medical planning software shows good reliability and can be used in preoperative planning and postoperative evaluations of HTOs. LEVEL OF EVIDENCE: I.

Indexed as

AdultHumansKneeLegMiddle AgedOsteoarthritis, KneeOsteotomyPatellaPhysical ExaminationPostureProspective StudiesRadiographyRange of Motion, ArticularReproducibility of ResultsTibiaClosing wedgeCorrection accuracyHigh tibial osteotomyKnee osteotomyLeg lengthOpening wedgePatellar heightPosterior tibial slope

Identifiers

PMID26467810
OpenAlexW1942070478

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.