Study: Lateral tibial intercondylar eminence is a reliable r
The purpose of the study was to determine whether the lateral tibial intercondylar eminence (LTIE) is a reliable reference for alignment correction in high tibial osteotomy (HTO).

A total of 1954 consecutive standing whole-leg radiography (WLR) examinations of 1373 adult patients with knee osteoarthritis were reviewed retrospectively; 145 patients were included. Virtual simulation of HTO was performed to measure weight-bearing line (WBL) percentages and hip–knee–ankle (HKA) angles when the WBL passed through the Fujisawa, top, bottom, upper 1/3, and middle points of the lateral slope of the LTIE, and the positional relationship between the Fujisawa point and the lateral slope of the LTIE was determined.

Results:
--When the WBL passed through the top, bottom, upper 1/3, and middle points of the lateral slope of the LTIE, the mean WBL percentages were 57.7%±2.1%, 74.6%±3.3%, 63.4%±2.1%, and 66.2%±2.3%, respectively, and the mean HKA angles were 182.1°±0.5°, 185.9°±0.8°, 183.3°±0.5°, and 184.0°±0.5°, respectively.

--When the WBL passed through the Fujisawa point, it was passing through 28.6%±12.7% of the width of the lateral slope.

--When the WBL passed through the middle and upper 1/3 points of the lateral slope of the LTIE, the majority of cases were within the limits of acceptability, as defined by the widely accepted standard of a postoperative HKA angle ranging from 183° to 186°.

Conclusively, the upper 1/3 and middle points of the lateral slope of the LTIE are reliable references for guiding the alignment correction in HTO. In clinical application, if 62%–66% of the postoperative WBL percentage is the acceptable target range, the upper 1/3 point of the lateral slope of the LTIE may be a better alternative than the midpoint. If the postoperative HKA angle between 183° and 186° is acceptable, the midpoint of the lateral slope of the LTIE may be better than the upper 1/3 point.

Source: https://link.springer.com/article/10.1007/s00167-021-06736-z
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