ArticleOrthopaedic surgery2021
Planning Results for High Tibial Osteotomies in Degenerative Varus Osteoarthritis Using Standing and Supine Whole Leg Radiographs.
Article in Orthopaedic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 3 citations in OpenAlex.
- Complementary roles of standing, supine, and valgus-stress whole-leg radiographs in medial open-wedge high tibial osteotomy planning: supine minimizes bias, whereas standing and valgus-stress reduce outliers.Knee surgery & related research · 2026Article
- Morphological approaches for optimizing lateral knee radiographs in normal knees and knees with osteoarthritis.Radiological physics and technology · 2026Article
- Comparison of Two-Dimensional and Three-Dimensional Preoperative Planning Measurements for High Tibial Osteotomy.Orthopaedic surgery · 2025Article
- Anatomical Study of the Lateral Tibial Spine as a Landmark for Weight Bearing Line Assessment during High Tibial Osteotomy.Medicina (Kaunas, Lithuania) · 2023Article
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Authors and funding
5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveIn this study, we hypothesized that standing and supine X-rays lead to different preoperative planning results.
methodsThe present study included 168 pictures from 81 patients who were treated surgically with high tibial osteotomy (HTO) for varus deformity between January 2017 and February 2018. Each patient underwent whole leg X-ray examinations in both standing and supine position. On both images, the following parameters were measured: degree of axis deviation (DAD), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), width of medial (MJS) and lateral joint space (LJS), and the correction angle (CA). The results were correlated with the patients' age and body mass index (BMI). To analyze intra-observer reliability, the same researcher, blinded to the previous measurements, remeasured all X-rays from 10 patients 8 weeks after the initial measurements were carried out.
resultsWhile mLDFA (P = 0.075), mMPTA (P = 0.435), and MJS (P = 0.119) did not show any differences between the two modalities, LJS (P = 0.016) and DAD (P < 0.001) differed significantly, leading to different correction angles (P < 0.001). The mean difference of the CA was 1.7° ± 2.2° (range, -2.6° to-15.4°). In 14 legs (17%), the standing X-ray led to a correction angle that was at least 3° larger than the calculation revealed in the supine X-ray; in 4 legs (5%), it was at least 5° larger. Increased BMI (r = 0.191, P = 0.088) and older age (r = 0.057 , P = 0.605) did not show relevant correlation with DAD differences. However, more severe varus malalignment in the supine radiograph did correlate moderately with differences of correction angles between supine and weight-bearing radiographs (r = 0.414, P < 0.001). The analysis of the intra-rater reliability revealed mediocre to excellent intercorrelation coefficients between the measurements of the observer.
conclusionThe use of supine and standing X-ray images leads to different planning results when performing high tibial osteotomies for varus gonarthrosis. To avoid potential overcorrection, surgeons might consider increased lateral joint spaces on standing radiographs in osteoarthritic knees with varus deviation.
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