Adequately increased postoperative medial proximal tibial angle can prevent medial joint space narrowing after open-wedge high tibial osteotomy: a 3-year cohort study.
4 affiliations
- 1Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. [email protected].
- 2Department of Orthopaedic Surgery, Aomori Rosai Hospital, Hachinohe, Japan.
- 3Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
- 4Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Abstract
Purpose
This study aimed to investigate the longitudinal relationship between postoperative medial proximal tibial angle (pMPTA) and joint space narrowing or osteophyte formation during a 3-year follow-up period after medial open-wedge high tibial osteotomy (MOWHTO).Methods
This retrospective cohort study included 133 knees of 101 patients (58 female patients; 77 female knees) who underwent MOWHTO [mean age: 57.5 ± 7.9 years; body mass index: 26.3 ± 4.0 kg/m²; 32 patients (19 female patients) underwent bilateral surgeries]. On the basis of plain radiograph until 1 month postoperatively (Post Op), pMPTA and change in MPTA (ΔMPTA) (i.e., [pMPTA] - [preoperative MPTA]) were measured. Additionally, the medial and lateral femorotibial joint space widths (MJSW/LJSW) and osteophyte area (MOPA/LOPA) were measured at Post Op, and the JSW and OPA were remeasured at 3-year follow-up (3Y). Amount of changes in JSW and OPA were measured using the following formula: Δ = [JSW3Y or OPA3Y] - [JSWPost Op or OPAPost Op]. If ΔMJSW was ≤ -0.3 mm, we defined medial knee osteoarthritis as progressed (p-mOA).Results
Forty-seven (35.3%) patients were diagnosed with p-mOA. Both pMPTA and ΔMPTA positively correlated with ΔMJSW. Receiver operating characteristic curves of pMPTA detected p-mOA, and the cut-off of pMPTA was 90°. Generalized estimation equations revealed that those with < 90° of correction for pMPTA demonstrated higher odds ratio of p-mOA (odds ratio: 3.300; 95% confidence interval: 1.327-8.198, p-value: 0.010), as compared with those with ≥ 90° correction. This finding was more robust in patients with preoperative Kellgren-Lawrence grade 0 or 1 (odds ratio: 5.408; 95% confidence interval: 1.400-20.905, p-value: 0.014), and ΔLJSW did not correlate with both pMPTA and ΔMPTA. Both the MOPA and LOPA increased during the 3-year follow-up period. However, there was no correlation between ΔOPA and pMPTA or ΔMPTA.Conclusions
Only in those with nonradiographic OA, correcting pMPTA with < 90° demonstrated a higher odds ratio of medial femorotibial joint space narrowing after MOWHTO when compared with those having ≥ 90° correction in the current short-term follow-up.Level of evidence
III.
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BibTeX
@article{chiba2026adequately,
title = {{Adequately increased postoperative medial proximal tibial angle can prevent medial joint space narrowing after open-wedge high tibial osteotomy: a 3-year cohort study.}},
author = {Daisuke Chiba and Shugo Maeda and Eiji Sasaki and Takahiro Tsushima and Yuka Kimura and Eiichi Tsuda and Yasuyuki Ishibashi},
journal = {Knee surgery \& related research},
year = {2026},
month = oct,
doi = {10.1186/s43019-026-00338-0},
url = {https://europepmc.org/article/MED/42958464},
note = {CC BY},
}
RIS
TY - JOUR
TI - Adequately increased postoperative medial proximal tibial angle can prevent medial joint space narrowing after open-wedge high tibial osteotomy: a 3-year cohort study.
AU - Daisuke Chiba
AU - Shugo Maeda
AU - Eiji Sasaki
AU - Takahiro Tsushima
AU - Yuka Kimura
AU - Eiichi Tsuda
AU - Yasuyuki Ishibashi
PY - 2026
DA - 2026/10/29
JO - Knee surgery & related research
DO - 10.1186/s43019-026-00338-0
UR - https://europepmc.org/article/MED/42958464
AB - Purpose This study aimed to investigate the longitudinal relationship between postoperative medial proximal tibial angle (pMPTA) and joint space narrowing or osteophyte formation during a 3-year follow-up period after medial open-wedge high tibial osteotomy (MOWHTO).Methods This retrospective cohort study included 133 knees of 101 patients (58 female patients; 77 female knees) who underwent MOWHTO [mean age: 57.5 ± 7.9 years; body mass index: 26.3 ± 4.0 kg/m²; 32 patients (19 female patients) underwent bilateral surgeries]. On the basis of plain radiograph until 1 month postoperatively (Post Op), pMPTA and change in MPTA (ΔMPTA) (i.e., [pMPTA] - [preoperative MPTA]) were measured. Additionally, the medial and lateral femorotibial joint space widths (MJSW/LJSW) and osteophyte area (MOPA/LOPA) were measured at Post Op, and the JSW and OPA were remeasured at 3-year follow-up (3Y). Amount of changes in JSW and OPA were measured using the following formula: Δ = [JSW3Y or OPA3Y] - [JSWPost Op or OPAPost Op]. If ΔMJSW was ≤ -0.3 mm, we defined medial knee osteoarthritis as progressed (p-mOA).Results Forty-seven (35.3%) patients were diagnosed with p-mOA. Both pMPTA and ΔMPTA positively correlated with ΔMJSW. Receiver operating characteristic curves of pMPTA detected p-mOA, and the cut-off of pMPTA was 90°. Generalized estimation equations revealed that those with < 90° of correction for pMPTA demonstrated higher odds ratio of p-mOA (odds ratio: 3.300; 95% confidence interval: 1.327-8.198, p-value: 0.010), as compared with those with ≥ 90° correction. This finding was more robust in patients with preoperative Kellgren-Lawrence grade 0 or 1 (odds ratio: 5.408; 95% confidence interval: 1.400-20.905, p-value: 0.014), and ΔLJSW did not correlate with both pMPTA and ΔMPTA. Both the MOPA and LOPA increased during the 3-year follow-up period. However, there was no correlation between ΔOPA and pMPTA or ΔMPTA.Conclusions Only in those with nonradiographic OA, correcting pMPTA with < 90° demonstrated a higher odds ratio of medial femorotibial joint space narrowing after MOWHTO when compared with those having ≥ 90° correction in the current short-term follow-up.Level of evidence III.
SN - 2234-0726
SN - 2234-2451
ER -