{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T15:03:40Z","timestamp":1775919820886,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The primary aim was to study the impact of joint line obliquity (JLO) on clinical outcomes and survivorship in patients undergoing total knee arthroplasty (TKA) after a previous high tibial osteotomy (HTO). The secondary aim was to study how maintaining neutral JLO at both HTO and TKA affected clinical outcomes of TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of patients undergoing TKA following valgus\u2010producing HTO, having a minimum 1\u2010year follow\u2010up, was performed. Using the coronal plane alignment of the knee (CPAK) classification, three groups of JLO were formed: distal JLO (&lt;177\u00b0), neutral JLO (177\u2013183\u00b0) and proximal JLO (&gt;183\u00b0). Clinical outcomes were assessed using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The level of significance was 0.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 110 TKA (mean follow\u2010up: 5.8 years). Prevalence of a proximal JLO post\u2010TKA was higher (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) in those with a proximal JLO pre\u2010TKA (40%) as compared to those with a neutral JLO pre\u2010TKA (13%). The odds ratio of having a proximal JLO post\u2010TKA was 4 (95% confidence interval: 1.4\u201311.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) in those having a proximal JLO pre\u2010TKA. Revision rate in the proximal JLO post\u2010TKA, neutral JLO post\u2010TKA and distal JLO post\u2010TKA groups was 20%, 8% and 4% respectively, with no statistical difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Post\u2010TKA, the stiffness, function and total WOMAC were significantly better (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) in patients with a neutral JLO pre\u2010TKA and neutral JLO post\u2010TKA as compared to those with a proximal JLO pre\u2010TKA and proximal JLO post\u2010TKA or a proximal JLO pre\u2010TKA and neutral JLO post\u2010TKA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While a proximal JLO after conversion TKA did not show a statistically higher revision rate, maintaining a neutral JLO during HTO and at the time of subsequent TKA was associated with higher post\u2010operative clinical scores. However, further research in different and larger populations is needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70612","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T10:41:46Z","timestamp":1768300906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improved clinical outcomes when maintaining a neutral joint line obliquity at high tibial osteotomy and subsequent total knee arthroplasty"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4683-8143","authenticated-orcid":false,"given":"Adit R.","family":"Maniar","sequence":"first","affiliation":[{"name":"London Health Sciences Center London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9428-9022","authenticated-orcid":false,"given":"Nicola D.","family":"Mackay","sequence":"additional","affiliation":[{"name":"London Health Sciences Center London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4455-0368","authenticated-orcid":false,"given":"Lyndsay","family":"Somerville","sequence":"additional","affiliation":[{"name":"London Health Sciences Center London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7291-2610","authenticated-orcid":false,"given":"Robert","family":"Litchfield","sequence":"additional","affiliation":[{"name":"London Health Sciences Center London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8176-3824","authenticated-orcid":false,"given":"Brent A.","family":"Lanting","sequence":"additional","affiliation":[{"name":"London Health Sciences Center London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4731-4333","authenticated-orcid":false,"given":"Alan M. J.","family":"Getgood","sequence":"additional","affiliation":[{"name":"London Health Sciences Center London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2017.7286"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42836-024-00239-1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12311"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12561"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-25-00920"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.04.004"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000000444"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1051\/sicotj\/2022009"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12349"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07394-z"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11420-013-9344-x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.106B10.BJJ-2023-1425.R1"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200112000-00014"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12168"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B2.BJJ-2020-1050.R1"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4680-x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.200934"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12175"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/10225536221132052"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520949552"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2020.10.011"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-020-03333-6"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2018.02.004"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2023.04.014"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70612","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70612","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70612","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T14:30:07Z","timestamp":1775917807000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/jeo2.70612"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70612","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70612"}}