Early Imaging Index Measurement And Clinical Effect Analysis After Medial Open Wedge High Tibial Osteotomy

Objective:Based on the imaging analysis,the changes of lower limb otomy lines after Medial open wedge high tibial osteotomy(MOWHTO)were studied,and the compensatory changes of hip joint,iliofemoral joint and ankle joint caused by the correction of lower limb otomy lines were measured.The clinical efficacy of MOWHTO was studied by functional scoring.Methods:Retrospective analysis on June 6,2016-December 2019 in our hospital surgical treatment and conforms to the data of 72 cases were included in the standard,to evaluate the postoperative lower limb power line correction,measurement of all patients with preoperative and postoperative readily and at the end of the follow-up of Hip,knee,ankle Angle(Hip knee-ankle Angle,HKA),distal lateral femoral Angle(lateral distal femoral Angle,LDFA),proximal tibial medial Angle(medial proximal tibial Angle,MPTA),joint line convergence Angle(JLCA),weight bearing line ratio(WBLR)and tibial Posterior slope(PTS).To evaluate the compensatory changes of Hip joint,patellofemoral joint,and ankle joint after OWHTO,the Hip abduction Angle(HAA),tibial plafond inclination Angle(TPI),Talar inclination Angle(TIA),Caton-Deschamps index,and Lateral patellar shift(Lateral patellar shift)were measured in all patients before and after the last follow-up,respectively.LPS),Lateral patellar tilt(LPT),medial space of patellofemoral joint,Lateral space of patellofemoral joint.Postoperative complications of all patients were followed up by outpatient and telephone visits.To evaluate the pain and functional recovery of the knee joint before and 6 months after surgery,The Hospital for Special Surgery Knee Score(HSS),Visual Analogue Scale(VAS)and Western Ontario and Mc Master Universities(WOMAC)scores were performed at 12 months and at the last follow-up.Results:1.A total of 49 patients were included in this study,all of whom were followed up for more than 1 year,with an average follow-up of 29.23 months.49 cases of patients,after MOWHTO complications occurred in 3 patients,the incidence was 6.12%,including incision infection,1 case(2.04%),lateral hinge fractures(Takeuchi Ⅲ type 1 case,Takeuchi II type 1 case)in 2 cases(4.08%),all patients were secondary surgery,after conservative treatment were recovered from these complications.2.After MOWHTO,the lower extremity line orthosis of the patients was satisfactory,and the comparison of HKA,JLCA,WBLR and MPTA before and immediately after the operation and the last follow-up showed statistical significance(P < 0.05).3.There was no increase of tibial posterior inclination after MOWHTO,and there was no statistically significant difference between preoperative and postoperative PTS(F=0.378,P =0.669).4.The hip adduction worsened after MOWHTO,and the difference between the preoperative and the last follow-up of HAA was statistically significant(F=21.620,P <0.05).Ankle varus was corrected after MOWHTO,and the difference between TPI,TIA and the last follow-up was statistically significant(F=24.682,P < 0.05;F=27.113,P < 0.05).5.After MOWHTO,the position of the patella decreased,but there was no anteropotential and lateral displacement,and no patella tilt.The Caton-Deschamps index was corrected from 0.95±0.12 before surgery to 0.84±0.11 at the last follow-up,and the difference was statistically significant(t=4.778,P < 0.05).6.After the last follow-up,knee pain was significantly reduced and knee function recovered well in all patients.Comparison of preoperative and postoperative follow-up results of HSS score,VAS score and WOMAC score showed statistically significant differences(F=253.676,P<0.05;F=81.641,P<0.05;F=113.637,P<0.05).Conclusion:MOWHTO treatment of knee osteoarthritis in the early stage of lower extremity line correction was satisfactory,hip joint adduction increased,ankle valgus decreased,the position of patella moved down,did not cause patella tilt,anteroposterior and lateral displacement,did not cause the increase of tibial posterior inclination.In the last follow-up study of all patients,the pain of the affected limb was relieved in the early stage after MOWHTO,and the function of the knee joint recovered well.