記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: The relationship between medial proximal tibial angle (MPTA) overcorrection and knee joint line obliquity (KJLO) after opening wedge high tibial osteotomy (OWHTO) remains controversial. Though excessive valgus correction (MPTA ≥ 95°) has been associated with abnormal joint line inclination, the extent to which this affects postoperative alignment and whether overcorrection necessarily results in excessive KJLO (≥5°), which has been associated with increased shear stress on the articular cartilage, is unclear. METHODS: A total of 300 knees undergoing isolated OWHTO were retrospectively reviewed. Postoperative KJLO and MPTA were measured using full-length standing radiographs. Knees were stratified into MPTA <95° and ≥95° groups. Correlations between postoperative MPTA and KJLO were analyzed, and in the overcorrected (MPTA ≥ 95°) group, logistic regression and receiver-operating characteristic (ROC) curve analyses were performed to identify preoperative predictors of postoperative KJLO ≥ 5°. RESULTS: Postoperative MPTA showed a significant positive correlation with KJLO (r = 0.61, p < 0.001). However, 52.5% of knees with MPTA ≥ 95° maintained KJLO < 5°, indicating that overcorrection does not necessarily cause excessive joint line inclination. Multivariable analysis identified preoperative lateral distal femoral angle (LDFA), knee joint line convergence angle (KJLCA), and ankle joint line obliquity (AJLO) as independent predictors of postoperative KJLO ≥ 5° in knees with MPTA ≥ 95° (p < 0.01). ROC curve analyses showed that AJLO ≥ 5.6°, LDFA ≥ 88.9°, and KJLCA ≥ 4.5° were the cutoff values predicting KJLO ≥ 5°. CONCLUSIONS: Although postoperative MPTA correlates with KJLO, more than half of the overcorrected cases maintained acceptable joint line inclination. Preoperative AJLO, LDFA, and KJLCA are key parameters for predicting postoperative KJLO ≥ 5° in knees with MPTA ≥ 95°, highlighting the importance of comprehensive preoperative alignment assessment when planning OWHTO.

DOI： 10.1051/sicotj/2026028

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

ObjectiveThis study aimed to evaluate clinical outcomes and cartilage repair following autologous chondrocyte implantation (ACI) combined with high tibial osteotomy (HTO) in elderly patients with spontaneous osteonecrosis of the knee (SONK) presenting with large cartilage defects.DesignEleven knees of 11 patients with SONK (lesion size ≥4 cm2) aged 60 years or older underwent ACI and concomitant opening-wedge HTO. Patients were followed for at least 1 year. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Cartilage repair was evaluated arthroscopically using the International Cartilage Repair Society (ICRS) grade and histologically using the ICRS II score at second-look arthroscopy.ResultsThe overall KOOS improved significantly from a preoperative value of 38.4 ± 8.5 to a 1-year postoperative value of 77.8 ± 10.9 (P < 0.01). Arthroscopy showed cartilage repair to normal or nearly normal in 91% of cases. The mean histological ICRS II score was 67.5 ± 16.2. No postoperative complications or need for additional surgical interventions was observed.ConclusionsACI combined with HTO provides good clinical and histological outcomes in elderly patients with SONK and large cartilage defects. This approach represents an effective joint-preserving treatment option, even in patients aged 60 years or older.

DOI： 10.1177/19476035251392531

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本関節病学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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