Evidence map›Paper›PMID 29804186›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

Retro-tubercular gap widening can be caused by inappropriate anterior osteotomy and large opening gap in the medial biplanar open-wedge HTO.

In Ho Jo, O-Sung Lee, Seung Hoon Lee, Kyung Wook Kim, Yong Seuk Lee

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

In Ho JoDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
O-Sung LeeDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Seung Hoon LeeDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Kyung Wook KimDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Yong Seuk LeeDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. smcos1@daum.net.
Seoul National University Bundang Hospital · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to investigate the causes of retro-tubercular gap widening and to confirm whether this widened gap causes instability of the osteotomy configuration during open-wedge high tibial osteotomy (OWHTO).

methodsOperative records and radiologic findings of patients who underwent biplanar medial OWHTO between 2014 and 2016 were retrospectively evaluated. To identify the osteotomy configuration including lateral hinge fracture, postoperative simple radiographs and CT images were analyzed. Postoperative CT scan was used to evaluate the widening of the retro-tubercular gap, thickness, and axial angle of retro-tubercular osteotomy, as well as the ratios of anterior and posterior osteotomy, and hinge length. The correlation of each factor was evaluated and analyzed in accordance with the lateral hinge fracture (LHF).

resultsWidening of the retro-tubercular gap showed a significant correlation with the axial angle of retro-tubercular osteotomy, anterior osteotomy ratio, and opening gap distance, but not with the thickness of retro-tubercular osteotomy, posterior osteotomy ratio, and hinge length ratio. The LHF group showed significantly larger value than the non-LHF group with respect to the thickness of retro-tubercular osteotomy (P = 0.003), axial angle of retro-tubercular osteotomy (P = 0.033), retro-planar gap distance (P = 0.001), anterior osteotomy ratio (P = 0.000), and opening gap distance (P = 0.003). The hinge length ratio was smaller in the LHF group than in the non-LHF group (P = 0.001). However, the posterior osteotomy ratio was not different between the two groups (n.s.).

conclusionRetro-tubercular gap widening can be caused by inappropriate anterior osteotomy and large opening gap distance, which can be related to LHF. Therefore, anterior cortical osteotomy may also be an important factor for preventing instability of the proximal fragment in biplanar OWHTO. LEVEL OF EVIDENCE: Case-control study, Level III.

Indexed as

AdultAgedCase-Control StudiesFemaleFractures, BoneHumansMaleMiddle AgedObserver VariationOsteoarthritis, KneeOsteotomyPostoperative PeriodProstheses and ImplantsRadiographyReproducibility of ResultsRetrospective StudiesBiplanar osteotomyHinge fractureKneeOpen-wedge high tibial osteotomyRetro-tubercular gapWidening

Identifiers

PMID29804186
OpenAlexW2804340081

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Registered trials

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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.