ArticleBMC musculoskeletal disorders2023
Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy?
Article in BMC musculoskeletal disorders, 2023. 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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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Optimal Plate Position for Biomechanical Stability in Medial Opening-Wedge High Tibial Osteotomy: A Finite Element Analysis.Clinics in orthopedic surgery · 2025Article
- Limited clinical benefit of medial meniscus posterior root repair combined with high tibial osteotomy in varus knee osteoarthritis: A systematic review and meta-analysis.Journal of experimental orthopaedics · 2025Review
- Novel anatomically contoured locking plate shows improved anatomic conformity vs. a conventional T-shaped plate in anterior popliteus transtibial-tuberosity high tibial osteotomy: a radiologic comparison.Frontiers in surgery · 2025Article
- Internal Brace Fixation Technique for Lisfranc Injury: A Retrospective Study.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring medial opening wedge high tibial osteotomy (MOWHTO), sometimes the plate tends to be positioned anteromedially. The plate position can affect the length of the proximal screw, which significantly affects stability after osteotomy. Therefore, research on the correlation among plate position, screw length, and clinical outcomes is needed.
methodsThis retrospective review examines 196 knees in 175 patients who underwent MOWHTO from May 2012 to December 2018, for symptomatic medial compartment osteoarthritis with a varus alignment of > 5°. We evaluated the anteroposterior plate position, length of proximal screw, and postoperative computed tomography (CT). We reviewed patients' clinical outcome scores, presence of lateral hinge fracture, neurovascular complications, and infection. The correlation among proximal plate position, proximal screw length, and clinical outcomes was evaluated using Pearson's correlation analysis. A subgroup analysis by screw angle (> 48 ° or < 48 °) was also performed using chi-square test and Student t-test.
resultsThe mean proximal plate position was 16.28% (range, 5.17-44.74) of the proximal tibia's anterior-to-posterior distance ratio, and the proximal screw length averaged 63.8 mm (range, 44-80 mm). Proximal posteromedial plate position and proximal screw length were significantly correlated (r2 = 0.667, P < .001), as were screw angle and length (r2 = 0.746, P < .001). Medial plating (< 48°) can use a longer proximal screw; nevertheless, no significant difference occurred in clinical outcomes between the two groups. Also, no differences occurred in complication rate, including hinge fracture.
conclusionWith more medially positioned plating during MOWHTO, we can use longer proximal screws. However, there was no significant difference in clinical outcomes and the incidence of lateral hinge fractures regardless of plate position and screw length.
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