MPTA on Full Standing and Rosenberg Views in Patients Undergoing High Tibial Osteotomy

Официальное название

Comparing Medial Proximal Tibial Angle Measurements on Full-leg Standing Radiographs and The Rosenberg View in Patients Undergoing High Tibial Osteotomy

Обзор

-Comparison of MPTA on both Full-leg Standing and Rosenberg Radiographs .

Подробное описание

The medial open wedge high tibial osteotomy (MOW-HTO) is awidely and successfully performed treatment for medial compartment osteoarthritis (OA) of the knee joint .

The primary goal of MOW-HTO is to alleviate mechanical stress onthe medial compartment of the knee joint by shifting the weight-bearing line (WBL) toward the lateral compartment .

Correct alignment is essential for achieving long-term success and favorable outcomes, making accurate preoperative planning crucial.

Accepted gold standard for preoperative coronal plane assessment of lower limb alignment are full-leg standing radiographs (FLSR) .

Measurement variables in the coronal plane include the mechanical lateral proximal femoral angle (mLPFA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle and mechanical lateral distal tibial angle.

However, alignment measurements are influenced by factors such as knee flexion, rotation, and loading conditions .

Identifying these factors prior to surgery is crucial to minimizing the risk of surgical error.

Posteroanterior weight-bearing radiographs taken with the knee in 45 degrees of flexion, commonly referred to as the Rosenberg view (RB), are routinely used preoperatively . This imaging technique not only facilitates the assessment of the severity of knee OA but also aids in evaluating the degree of soft tissue laxity contributing to varus alignment-a factor increasingly recognized for its clinical significance .

For knowledge, one study has investigated how knee alignment parameters used for planning of HTO differ when measured using the RB .

The invistegator hypothesize that the medial proximal tibial angle (MPTA) does not differ when measured on RB radiographs compared with FLSR. Being a widely accessible and commonly used imaging technique, if confirmed, this finding would suggest that the RB could serve as a com-plementary modality for preoperative planning for MOW-HTO.

Вмешательства

• Устройство X-ray
  comparing of MPTA on full standing and rosenberg views

Первичные конечные точки

• Difference in medial proximal tibial angle (MPTA) measurments in both the Rosenberg view and full-leg standing radiographic position [Срок оценки: Baseline]

Критерии участия

Критерии включения

• All patients were screened for medial compartment OA of either the left or right knee joint.
• Availability of preoperative full-length standing radiograph and Rosenberg view.
• Completeness of patient records .
• Patient consent

Критерии исключения

• Insufficient patient records .
• Previous ligamentous surgery or osteotomies .
• Known neuromuscular or metabolic disorder .
• Absence of a radiographic reference ball.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Публикации

• Ogata K, Yoshii I, Kawamura H, Miura H, Arizono T, Sugioka Y. Standing radiographs cannot determine the correction in high tibial osteotomy. J Bone Joint Surg Br. 1991 Nov;73(6):927-31. doi: 10.1302/0301-620X.73B6.1955438. PMID 1955438
• Deep K, Eachempati KK, Apsingi S. The dynamic nature of alignment and variations in normal knees. Bone Joint J. 2015 Apr;97-B(4):498-502. doi: 10.1302/0301-620X.97B4.33740. PMID 25820888
• Palmer J, Getgood A, Lobenhoffer P, Nakamura R, Monk P. Medial opening wedge high tibial osteotomy for the treatment of medial unicompartmental knee osteoarthritis: A state-of-the-art review. J ISAKOS. 2024 Feb;9(1):39-52. doi: 10.1016/j.jisako.2023.10.004. Epub 2023 Oct 13. PMID 37839705
• Dugdale TW, Noyes FR, Styer D. Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res. 1992 Jan;(274):248-64. PMID 1729010
• Yasuda K, Majima T, Tsuchida T, Kaneda K. A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res. 1992 Sep;(282):186-95. PMID 1516311
• Hernigou P, Medevielle D, Debeyre J, Goutallier D. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am. 1987 Mar;69(3):332-54. PMID 3818700
• Coventry MB, Ilstrup DM, Wallrichs SL. Proximal tibial osteotomy. A critical long-term study of eighty-seven cases. J Bone Joint Surg Am. 1993 Feb;75(2):196-201. doi: 10.2106/00004623-199302000-00006. PMID 8423180
• COVENTRY MB. OSTEOTOMY OF THE UPPER PORTION OF THE TIBIA FOR DEGENERATIVE ARTHRITIS OF THE KNEE. A PRELIMINARY REPORT. J Bone Joint Surg Am. 1965 Jul;47:984-90. No abstract available. PMID 14318636

Идентификаторы

NCT: NCT07493733 · Comparison of MPTA in two view

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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