{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T04:20:54Z","timestamp":1793766054201,"version":"4.6.1"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"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":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantitatively evaluate anterior cortical defect remodelling and bone healing following infra\u2010tubercle anterior closing\u2010wedge high tibial osteotomy (ACW\u2010ITO) and to identify clinical and surgical factors associated with remodelling. We hypothesised that substantial spontaneous remodelling would occur, that greater slope correction would result in larger initial defects with greater regrowth, and that patient\u2010related factors would influence remodelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort of 100 consecutive patients undergoing infra\u2010tubercle slope\u2010reducing osteotomy was analysed. Standardised lateral radiographs were obtained preoperatively, immediately postoperatively, at regular intervals until consolidation, and at 12 months. Defect area (mm\n                      <jats:sup>2<\/jats:sup>\n                      ) and step\u2010off height (mm) were measured using calibrated digital imaging. Remodelling was expressed as percentage reduction from post\u2010operative to final follow\u2010up. Associations between remodelling and clinical variables were assessed using univariate and multivariable analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean defect area decreased from 82.6\u2009\u00b1\u200921.3\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      postoperatively to 31.8\u2009\u00b1\u200919.4\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      at final follow\u2010up, corresponding to 60.7%\u2009\u00b1\u200923.3% regrowth (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Step\u2010off height decreased from 6.0\u2009\u00b1\u20091.6\u2009mm to 2.8\u2009\u00b1\u20091.4\u2009mm (51.7%\u2009\u00b1\u200923.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Radiographic union was achieved in 98% of cases by 4 months and 100% by 6 months, with no cases of non\u2010union or hinge fracture. Multivariable analysis identified age, body mass index (BMI), smoking status, and sex as independent predictors of remodelling, while slope correction was not independently associated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anterior cortical defects following ACW\u2010ITO undergo consistent and substantial remodelling within the first post\u2010operative year. While greater slope correction produces larger initial defects, neither the magnitude of correction nor the initial defect size independently determines the extent of remodelling, partially refuting our pre\u2010specified second hypothesis. These findings suggest that the immediate post\u2010operative step\u2010off undergoes substantial remodelling over time and should not be interpreted as a marker of impaired healing, even when considerable residual defect persists at 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70536","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:10:34Z","timestamp":1784268634000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anterior cortical defects following infra\u2010tubercle slope\u2010reducing osteotomy show consistent remodelling without impairing union: A radiographic study with 12\u2010month follow\u2010up"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9537-0658","authenticated-orcid":false,"given":"Tomas","family":"Pineda","sequence":"first","affiliation":[{"name":"Facultad de Medicina, Hospital del Trabajador Universidad Andre\u0301s Bello Santiago Chile"},{"name":"Facultad de Medicina, Hospital el Carmen Universidad Finis Terrae Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romir","family":"Patel","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Marseille, Institute for Locomotion Marseille France"},{"name":"Department of Biomechanics, CNRS, ISM Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arian Khajeh","family":"Vi","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Marseille, Institute for Locomotion Marseille France"},{"name":"Department of Biomechanics, CNRS, ISM Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6446-4985","authenticated-orcid":false,"given":"Rodrigo","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Hospital del Trabajador Universidad Andre\u0301s Bello Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Piercecchi","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Marseille, Institute for Locomotion Marseille France"},{"name":"Department of Biomechanics, CNRS, ISM Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Jacquet","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Marseille, Institute for Locomotion Marseille France"},{"name":"Department of Biomechanics, CNRS, ISM Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-0873","authenticated-orcid":false,"given":"Matthieu","family":"Ollivier","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Marseille, Institute for Locomotion Marseille France"},{"name":"Department of Biomechanics, CNRS, ISM Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"issue":"7","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1177\/03635465251334649","article-title":"Sagittal slope\u2010reducing high tibial osteotomy decreases anterior cruciate ligament force and coupled internal tibial rotation under pivoting loads: a computational modeling study","volume":"53","author":"Amirtharaj MJ","year":"2025","journal-title":"Am J Sports 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