Evidence map›Paper›PMID 28831525›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Large correction in opening wedge high tibial osteotomy with resultant joint-line obliquity induces excessive shear stress on the articular cartilage.

Hiroshi Nakayama, Steffen Schröter, Chie Yamamoto, Tomoya Iseki, Ryo Kanto, Kenji Kurosaka, Shunichiro Kambara, Shinichi Yoshiya, Masaru Higa

Abstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 125 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
125citing papers in PubMed, 1 pooled it
10.2field-weighted citation impact, top 1% 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

125 citing papers in PubMed, 1 synthesis or guideline pooled it, 250 citations in OpenAlex.

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  19. Mid-term survival and physiological joint angles after double level osteotomy of severe varus osteoarthritis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025
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65 more citing papers are in PubMed but not listed here.

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

9 authors at 2 institutions in 1 country.

Hiroshi NakayamaDepartment of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Steffen SchröterBG Trauma Center Tübingen, Schnarrenberg str. 95, Tübingen, Germany.
Chie YamamotoDepartment of Mechanical Engineering, University of Hyogo, 2167 Shosha, Himeji, Hyogo, 671-2280, Japan.
Tomoya IsekiDepartment of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Ryo KantoDepartment of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Kenji KurosakaDepartment of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Shunichiro KambaraDepartment of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Shinichi YoshiyaDepartment of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Masaru HigaDepartment of Mechanical Engineering, University of Hyogo, 2167 Shosha, Himeji, Hyogo, 671-2280, Japan. higa@eng.u-hyogo.ac.jp.
Hyogo Medical University · JPUniversity of Hyogo · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to analyse the resultant stress induced by joint-line obliquity after HTO for varus knee deformity using a three-dimensional (3D) finite element model analysis.

methodsThe geometrical bone data used in this study were derived from commercially available human bone digital anatomy media. The 3D knee models were developed using 3D computer-aided design software. The articular surface was overlaid with a 2-mm-thick cartilage layer for both femoral and tibial condyles. Ligament structures were simulated based on properties reported in previous anatomical studies. Regarding the loading condition, isolated axial loads of 1200 N with lateral joint-line inclinations of 2.5°, 5°, 7.5°, and 10° in reference to the horizontal axis were applied to the femur to simulate the mechanical environment in a knee with joint-line obliquity.

resultsA steep rise of shear stress in the medial compartment was noted in the model with obliquity of 5° or more. This laterally directed shear stress exhibited an incremental increase in accordance with the obliquity angle. The maximum shear stress value in the medial cartilage increased from 1.6 MPa for the normal knee to 3.3, 5.2, and 7.2 MPa in the joint-line obliquity models with 5°, 7.5°, and 10° of obliquity, respectively.

conclusionsThe effects of HTO for varus knee deformity on the amount/distribution of stresses in the articular cartilage were analysed using a 3D finite element model. It was shown that joint-line obliquity of more than 5° induced excessive shear stress in the tibial articular cartilage. A large amount of correction in OWHTO with a resultant joint-line obliquity of 5° or more may induce detrimental stress to the articular cartilage. Double-level osteotomy should be considered as a surgical option in this situation.

Indexed as

Cartilage, ArticularFinite Element AnalysisGenu VarumHumansImaging, Three-DimensionalKnee JointOsteoarthritis, KneeOsteotomyStress, MechanicalTibiaFinite element modellingHigh tibial osteotomyJoint-line obliquityKnee

Identifiers

PMID28831525
OpenAlexW2745801064

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.