Patients with varus knee OA undergoing high tibial osteotomy
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The aim of this study was to compare alignment parameters between patients undergoing high tibial osteotomy (HTO) for knee osteoarthritis (OA) and non-arthritic controls.

Pre-operative computed tomography images from 194 patients undergoing HTO for medial knee OA and 118 non-arthritic controls were utilized. All patients had varus knee alignment (mean age: 57±11 years; 45% female). The hip-knee-ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA) and non-weight-bearing joint line convergence angle (nwJLCA) were compared between “control group” and “HTO group”.
-Femoral and tibial phenotypes were also assessed and compared between groups. Variables found on univariate analysis to be different between the groups were entered into a binary logistic regression model.

Results:
The mean age was lower (delta = 4±6 years), body mass index (BMI) was higher (delta = 1.1±2.8 kg/m2) and there were more females (delta = 14%) in the HTO group.
-The HTO group had more overall varus (7°±4.7° vs 4.8°±1.3°). -There was a significant difference in the mean mLDFA between the two groups with the HTO group having more femoral varus (88.7±3.2° vs 87.3±1.8°).
-MPTA was similar between the groups. Age was found to be a strong determinant for femoral varus.

In particular, patients undergoing HTO for medial knee OA have more femoral varus compared to non-arthritic controls while tibial morphology was similar. This will be an important consideration in pre-operating planning for realignment osteotomy in patients presenting with medial knee OA and warrants further investigation.

Source: https://link.springer.com/article/10.1007/s00167-020-06426-2
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