ArticleJournal of experimental orthopaedics2026
Lack of evidence for an effect of joint line obliquity after medial opening wedge high tibial osteotomy: A 12-year single-centre retrospective study.
Article in Journal of experimental orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Large correction in opening wedge high tibial osteotomy (HTO) may lead to excessive joint line obliquity (JLO). This study hypothesized that the presence of an oblique joint line, defined by knee joint line obliquity (KJLO) > 5° and/or medial proximal tibial angle (MPTA) > 94°, was associated with poorer functional outcomes and lower survival rates following HTO at long-term follow-up. Methods: This retrospective study included 83 patients who underwent a medial opening wedge HTO with at least 5 years of follow-up. Complete pre- and postoperative radiographic parameters (hip-knee-ankle angle [HKA], MPTA, lateral distal femoral angle [LDFA], KJLO, joint line convergence angle [JLCA]) and functional outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], International Knee Society Score [IKS], Subjective Knee Value [SKV]) were analysed. Excessive JLO was defined by a KJLO ≥ 5° and/or an MPTA > 94°. An independent Student's Results: The HKA, MPTA, JLCA and KJLO angles varied significantly (ΔHKA = 7.8° ± 3.7, Conclusion: This retrospective analysis found no significant association between excessive JLO (KJLO ≥ 5° and/or MPTA > 94°) and either survival or functional outcomes after medial opening wedge HTO at a mean follow-up of 12 years. Factors negatively influencing survival after HTO were smoking, age > 55 years, advanced osteoarthritis and out-of-target postoperative alignment. These findings should be confirmed by larger series. Level of Evidence: Level III.
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