{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:30:20Z","timestamp":1780533020657,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RF\u20102018\u201012368274"],"award-info":[{"award-number":["RF\u20102018\u201012368274"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate changes in medial and lateral knee contact forces during walking, stair ascent and stair descent following open\u2010wedge high tibial osteotomy, and to assess their association with changes in patient\u2010reported symptoms and function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010two patients with medial knee osteoarthritis and varus malalignment were recruited and subdivided into two groups according to a partially randomised patient\u2010preference design. Three patients dropped out at follow\u2010up, resulting in a cohort of 49 patients who underwent either high tibial osteotomy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) or conservative treatment (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924). Motion capture and radiographic data, as well as patient\u2010reported outcome measures (knee injury and osteoarthritis outcome score [KOOS] and visual analogue scale [VAS]), were collected pre\u2010 and post\u2010treatment at an average 17.8\u2010month follow\u2010up. Personalised computational models of the musculoskeletal system incorporating tibiofemoral alignment and joint space narrowing were used to estimate medial, lateral and total knee contact forces during walking, stair ascent and stair descent. Changes in joint forces and their distribution were statistically analysed and correlated with changes in the patient\u2010reported outcome measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      High tibial osteotomy led to a consistent redistribution of knee contact forces from the medial to the lateral compartment, with mean reductions in medial forces of up to 0.50 body\u2010weight and mean increases in lateral forces of up to 0.65 body\u2010weight (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), across all activities. Conservative treatment resulted in no significant changes. Patient\u2010reported outcomes improved significantly following surgery; however, only weak associations were observed between changes in knee internal loading and improvements in symptoms or function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High tibial osteotomy effectively unloads the knee medial compartment and redistributes knee internal loads between the medial and lateral compartments during walking and stair tasks. However, the limited correlation with subjective recovery suggests that additional factors beyond load redistribution likely influence clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70348","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:47:08Z","timestamp":1772988428000},"page":"1787-1801","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High tibial osteotomy leads to medial\u2010lateral redistribution of knee internal forces during walking and stair ambulation and improves patient\u2010reported outcomes"],"prefix":"10.1002","volume":"34","author":[{"given":"Giulia","family":"Grenno","sequence":"first","affiliation":[{"name":"IRCCS Istituto Ortopedico Rizzoli, Bioengineering and Computing Laboratory Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-8192","authenticated-orcid":false,"given":"Giordano","family":"Valente","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Rizzoli, Bioengineering and Computing Laboratory Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo Dal","family":"Fabbro","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Rizzoli, Bologna, 2nd Orthopedics and Trauma Unit  Italy"},{"name":"Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Macchiarola","sequence":"additional","affiliation":[{"name":"Orthopedics Department IRCCS Casa Sollievo Della Sofferenza San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Grassi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Rizzoli, Bologna, 2nd Orthopedics and Trauma Unit  Italy"},{"name":"Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Zaffagnini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Rizzoli, Bologna, 2nd Orthopedics and Trauma Unit  Italy"},{"name":"Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvia","family":"Taddei","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Rizzoli, Bioengineering and Computing Laboratory Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10255849908907988"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bor.0000240365.16842.4e"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/app132212425"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24466"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2022.105855"},{"key":"e_1_2_12_7_1","first-page":"1009","article-title":"Partially randomized preference trial design","volume":"2","author":"Bradley\u2010Gibride J","year":"2010","journal-title":"Encycl Res Des Sage"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2014.01.038"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-15-280"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25403"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2007.901024"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2021.10.010"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.09.012"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20543"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.02.015"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05509-z"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25001"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2011.01.015"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2006.12.018"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","unstructured":"LeeSH Lee OS Teo SH Lee YS. 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