{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T18:05:55Z","timestamp":1773597955526,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T00:00:00Z","timestamp":1611446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T00:00:00Z","timestamp":1611446400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T00:00:00Z","timestamp":1611446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Preoperatively planned correction for tibial osteotomy surgery is usually based on weightbearing long\u2010leg Xrays, while the surgery is performed in a supine non\u2010weightbearing position. The purpose of this study was to assess the differences in lower limb alignment in three different weightbearing conditions: supine position, double\u2010leg (DL) stance and single\u2010sleg (SL) stance prior to performing a medial opening wedge high tibial osteotomy (MOWHTO) for varus malalignment. The hypothesis of this study was that progressive limb\u2010loading would lead to an increased preoperative varus deformity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This retrospective study included 89 patients (96\u00a0knees) with isolated medial knee osteoarthritis (Ahlb\u00e4ck grade I or II) and significant metaphyseal tibial vara (&gt;\u20096\u00b0). The differences between supine position, DL stance and SL stance were analysed for the hip\u2010knee\u2010ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), weight\u2010bearing line ratio (WBL) and joint line convergence angle (JLCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From a supine position to DL stance, the HKA angle slightly increased from 175.5\u00b0\u2009\u00b1\u20091.1\u00b0 to 176.3\u00b0\u2009\u00b1\u20091.1\u00b0 and JLCA changed from 2.0\u00b0\u2009\u00b1\u20090.3\u00b0 to 1.8\u00b0\u2009\u00b1\u20090.3\u00b0 without a statistically significant difference. From DL to SL stances, the HKA angle decreased from 176.3\u00b0\u2009\u00b1\u20091.1\u00b0 to 174.4\u00b0\u2009\u00b1\u20091.1\u00b0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and the JLCA increased from 1.8\u00b0\u2009\u00b1\u20090.3\u00b0 to 2.6\u00b0\u2009\u00b1\u20090.3\u00b0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). A significant correlation was found between \u0394HKA and \u0394JLCA between the DL and the SL stances (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.46; <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Varus malalignment increases with weight\u2010bearing loading from double\u2010leg to single\u2010leg stances with an associated JLCA increase. Thus, single\u2010leg stance radiographs may be useful to correct preoperative planning considering patient\u2010specific changes in JLCA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of clinical evidence<\/jats:title><jats:p>III, retrospective comparative study.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06446-6","type":"journal-article","created":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T06:02:27Z","timestamp":1611468147000},"page":"715-720","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Global varus malalignment increase from double\u2010leg to single\u2010leg stance due to intra\u2010articular changes"],"prefix":"10.1002","volume":"30","author":[{"given":"L\u00e9o\u2010P\u00f4hl","family":"Bardot","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedics and Traumatology, Institute of Movement and Locomotion St. Marguerite Hospital BP 29 270 Boulevard Sainte Marguerite 13274 Marseille France"},{"name":"<!--<label>2<\/label>--> Department of Orthopedics and Traumatology, Institute for Locomotion, APHM, CNRS, ISM, Sainte\u2010Marguerite Hospital Aix Marseille University Marseille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gr\u00e9goire","family":"Micicoi","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopedics and Traumatology, Institute for Locomotion, APHM, CNRS, ISM, Sainte\u2010Marguerite Hospital Aix Marseille University Marseille France"},{"name":"<!--<label>3<\/label>--> iULS\u2010University Institute for Locomotion and Sports, Pasteur 2 Hospital, University C\u00f4te d\u2019Azur Nice France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henri","family":"Favreau","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Service de Chirurgie Orthopedique et de TraumatologieH\u00f4pital de Hautepierre H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petr","family":"Zeman","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedics and Traumatology, Institute of Movement and Locomotion St. Marguerite Hospital BP 29 270 Boulevard Sainte Marguerite 13274 Marseille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghbir","family":"Khakha","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopedics and Traumatology, Institute for Locomotion, APHM, CNRS, ISM, Sainte\u2010Marguerite Hospital Aix Marseille University Marseille France"},{"name":"<!--<label>5<\/label>--> Guys and St Thomas\u2019 Hospitals Great Maze Pond SE1 9RT London England"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthieu","family":"Ehlinger","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Service de Chirurgie Orthopedique et de TraumatologieH\u00f4pital de Hautepierre H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthieu","family":"Ollivier","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedics and Traumatology, Institute of Movement and Locomotion St. Marguerite Hospital BP 29 270 Boulevard Sainte Marguerite 13274 Marseille France"},{"name":"<!--<label>2<\/label>--> Department of Orthopedics and Traumatology, Institute for Locomotion, APHM, CNRS, ISM, Sainte\u2010Marguerite Hospital Aix Marseille University Marseille France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,24]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101616\u20108"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B5.20386"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2012.07.009"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200001000\u201000009"},{"key":"e_1_2_9_6_2","doi-asserted-by":"crossref","unstructured":"JacquetC SharmaA FabreM EhlingerM ArgensonJ\u2010N ParratteS OllivierM(2019) Patient\u2010specific high\u2010tibial osteotomy\u2019s \u2018cutting\u2010guides\u2019 decrease operating time and the number of fluoroscopic images taken after a Brief Learning Curve.Knee Surg Sports Traumatol 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A new fixation device.Clin Orthop Relat Res250\u2013259","DOI":"10.1097\/00003086-198909000-00035"},{"key":"e_1_2_9_17_2","first-page":"437","article-title":"Assessment and validation of CT scanogram to compare per\u2010operative and post\u2010operative mechanical axis after navigated total knee replacement","volume":"33","author":"Mohanlal P","year":"2009","journal-title":"IntOrthop"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010016\u20102521\u2010x"},{"key":"e_1_2_9_19_2","doi-asserted-by":"crossref","unstructured":"ParkJ\u2010G KimJ\u2010M LeeB\u2010S LeeS\u2010M KwonO\u2010J BinS\u2010I(2019) Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy.Knee Surg Sports Traumatol Arthrosc","DOI":"10.1007\/s00167-019-05805-8"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102687\u20105"},{"key":"e_1_2_9_21_2","first-page":"204","article-title":"High Tibial Osteotomy: A Systematic Review and Current Concept","volume":"4","author":"Sabzevari S","year":"2016","journal-title":"Arch Bone JtSurg"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005555\u20107"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506293024"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010008\u20100698\u20104"},{"key":"e_1_2_9_25_2","first-page":"85","article-title":"Discrepancy of alignment in different weight bearing conditions before and after high tibial osteotomy","volume":"41","author":"Wang JH","year":"2017","journal-title":"IntOrthop"},{"key":"e_1_2_9_26_2","first-page":"174","article-title":"Comparison of Double and Single Leg Weight\u2010Bearing Radiography in Determining Knee Alignment","volume":"5","author":"Yazdanpanah O","year":"2017","journal-title":"Arch Bone JtSurg"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.16.052"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-021-06446-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-021-06446-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-021-06446-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-021-06446-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T08:38:56Z","timestamp":1760863136000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-021-06446-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,24]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1007\/s00167-021-06446-6"],"URL":"https:\/\/doi.org\/10.1007\/s00167-021-06446-6","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,24]]},"assertion":[{"value":"3 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"LB, GM, RK have nothing to disclose. MO is educational consultant for Stryker, AO-Recon and Newclip-Technics. ME is educational consultant for Amplitude, Groupe L\u00e9pine and Newclip-Technics.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The local ethics committee approved our study protocol prior to investigation.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"NA.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}