Description
The principle of an open wedge high tibial osteotomy (HTO) is to achieve a neutral or slightly valgus limb alignment, redistributing weight-bearing to the healthy lateral knee compartment. This realignment results in significant alterations in the medial proximal tibial angle (MPTA), subsequently affecting knee joint line orientation (KJLO). Our study highlights the challenge of predicting postoperative KJLO using solely MPTA. The traditional KJLO measurement lacks standardization due to variations in foot positioning, hindering its predictive value. However, by adjusting the KJLO measurement to account for foot positioning, we developed a novel measurement —adjusted KJLO (aKJLO)— which enabled a more accurate prediction of postoperative KJLO relative to MPTA. This method can help inform surgical decision-making, particularly in choosing between single or double-level osteotomies to prevent excessive postoperative joint line obliquity (>4° KJLO).
