No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population

Purpose: This study aims to assess the significance of post-operative change in limb length in medial opening wedge high tibial osteotomy (MOWHTO), and evaluate the correlation between correction angles and changes in limb length. We hypothesize that opening wedge height and correction angles direct...

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Main Authors: Betzler, Brjan Kaiji, Saggi, Sandip Singh, Liau, Matthias Yi Quan, Koh, Don Thong Siang, Lee, Kong Hwee, Hamid Rahmatullah Bin Abd Razak
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
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Language:English
Published: 2024
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Online Access:https://hdl.handle.net/10356/173526
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spelling sg-ntu-dr.10356-1735262024-02-18T15:38:11Z No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population Betzler, Brjan Kaiji Saggi, Sandip Singh Liau, Matthias Yi Quan Koh, Don Thong Siang Lee, Kong Hwee Hamid Rahmatullah Bin Abd Razak Lee Kong Chian School of Medicine (LKCMedicine) Medicine, Health and Life Sciences Osteoarthritis High Tibial Osteotomy Purpose: This study aims to assess the significance of post-operative change in limb length in medial opening wedge high tibial osteotomy (MOWHTO), and evaluate the correlation between correction angles and changes in limb length. We hypothesize that opening wedge height and correction angles directly correlate to changes in limb length. Methods: The medical records and radiographs of 91 MOWHTO patients were retrospectively evaluated for relevant radiographical parameters both pre- and post-operatively. The exclusion criteria are: (i) concurrent distal femur osteotomy in the same setting, (ii) other previous unilateral lower limb surgeries prior to MOWHTO and (iii) failure to follow-up with post-operative radiographs. A linear regression model was performed and a line of best fit, Pearson's correlation coefficient (r) and coefficient of determination (R 2) were computed. Chi-squared test was also performed, and results with P < 0.05 were considered statistically significant. Results: There is a statistically significant increase in post-MOWHTO limb length (Absolute Δ = 4.3 ± 2.86 mm, % Δ = 0.652% ± 0.434%, p < 0.001). There was no significant difference in the limb length change between patients with larger (> 8 mm) and smaller (< 8 mm) opening widths. There was a weakly positive correlation between limb length change versus actual (R 2 = 0.140, 95%CI [-0.068, 0.336]) and planned correction angles (R 2 = 0.196, 95%CI [-0.012, 0.387]). Conclusion: In conclusion, post-MOWHTO change in limb length is statistically significant, but the clinical significance is minimal. Further studies are required to assess other factors. Development of a reliable mathematical model that predicts post-MOWHTO limb length change would be useful in predicting the anatomical outcomes. Level of evidence: Level III. Retrospective Cohort Study. Published version 2024-02-13T00:50:50Z 2024-02-13T00:50:50Z 2023 Journal Article Betzler, B. K., Saggi, S. S., Liau, M. Y. Q., Koh, D. T. S., Lee, K. H. & Hamid Rahmatullah Bin Abd Razak (2023). No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population. Journal of Experimental Orthopaedics, 10(1), 89-. https://dx.doi.org/10.1186/s40634-023-00654-4 2197-1153 https://hdl.handle.net/10356/173526 10.1186/s40634-023-00654-4 37644360 2-s2.0-85169001474 1 10 89 en Journal of Experimental Orthopaedics © The Author(s) 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Medicine, Health and Life Sciences
Osteoarthritis
High Tibial Osteotomy
spellingShingle Medicine, Health and Life Sciences
Osteoarthritis
High Tibial Osteotomy
Betzler, Brjan Kaiji
Saggi, Sandip Singh
Liau, Matthias Yi Quan
Koh, Don Thong Siang
Lee, Kong Hwee
Hamid Rahmatullah Bin Abd Razak
No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population
description Purpose: This study aims to assess the significance of post-operative change in limb length in medial opening wedge high tibial osteotomy (MOWHTO), and evaluate the correlation between correction angles and changes in limb length. We hypothesize that opening wedge height and correction angles directly correlate to changes in limb length. Methods: The medical records and radiographs of 91 MOWHTO patients were retrospectively evaluated for relevant radiographical parameters both pre- and post-operatively. The exclusion criteria are: (i) concurrent distal femur osteotomy in the same setting, (ii) other previous unilateral lower limb surgeries prior to MOWHTO and (iii) failure to follow-up with post-operative radiographs. A linear regression model was performed and a line of best fit, Pearson's correlation coefficient (r) and coefficient of determination (R 2) were computed. Chi-squared test was also performed, and results with P < 0.05 were considered statistically significant. Results: There is a statistically significant increase in post-MOWHTO limb length (Absolute Δ = 4.3 ± 2.86 mm, % Δ = 0.652% ± 0.434%, p < 0.001). There was no significant difference in the limb length change between patients with larger (> 8 mm) and smaller (< 8 mm) opening widths. There was a weakly positive correlation between limb length change versus actual (R 2 = 0.140, 95%CI [-0.068, 0.336]) and planned correction angles (R 2 = 0.196, 95%CI [-0.012, 0.387]). Conclusion: In conclusion, post-MOWHTO change in limb length is statistically significant, but the clinical significance is minimal. Further studies are required to assess other factors. Development of a reliable mathematical model that predicts post-MOWHTO limb length change would be useful in predicting the anatomical outcomes. Level of evidence: Level III. Retrospective Cohort Study.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Betzler, Brjan Kaiji
Saggi, Sandip Singh
Liau, Matthias Yi Quan
Koh, Don Thong Siang
Lee, Kong Hwee
Hamid Rahmatullah Bin Abd Razak
format Article
author Betzler, Brjan Kaiji
Saggi, Sandip Singh
Liau, Matthias Yi Quan
Koh, Don Thong Siang
Lee, Kong Hwee
Hamid Rahmatullah Bin Abd Razak
author_sort Betzler, Brjan Kaiji
title No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population
title_short No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population
title_full No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population
title_fullStr No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population
title_full_unstemmed No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population
title_sort no significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic southeast asian population
publishDate 2024
url https://hdl.handle.net/10356/173526
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