{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T14:15:54Z","timestamp":1776780954831,"version":"3.51.2"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T00:00:00Z","timestamp":1630800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T00:00:00Z","timestamp":1630800000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T00:00:00Z","timestamp":1630800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008375","name":"Universit\u00e4t Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008375","name":"Universit\u00e4t Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"publisher"}]}],"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>The purpose of this study was to investigate whether specific bone tracer uptake (BTU) patterns on preoperative SPECT\/CT could predict which patients with varus alignment and medial overload would particularly benefit from medial opening\u2010wedge high tibial osteotomy (MOWHTO). It was the hypothesis that an increased preoperative BTU relative to the reference BTU of the femur on SPECT\/CT in the lateral and patellar compartments of the knee are predictive factors for inferior clinical outcome and that the clinical outcome correlates with the extent of alignment correction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010three knees from 22 patients who underwent MOWHTO for medial compartment overload were investigated preoperatively using Tc\u201099m\u2010SPECT\/CT. BTU was quantified and localised to specific joint areas according to a previously validated scheme. Pre\u2010 and postoperative mechanical alignment was measured. Clinical outcome was assessed at a median of 24\u00a0months (range 11\u201330) after MOWHTO by collecting the WOMAC score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant correlations between BTU in the patellar area and the total WOMAC score and its subcategories pain and stiffness were found. Thus, BTU in the 1sPat area (superior lateral patellar compartment) correlated with total WOMAC (rho\u2009=\u20090.43, <jats:italic>p<\/jats:italic>\u2009=\u20090.04), pain subcategory (rho\u2009=\u20090.43, <jats:italic>p<\/jats:italic>\u2009=\u20090.04), and stiffness subcategory (rho\u2009=\u20090.59, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). No significant correlations were found between alignment correction, age, gender and WOMAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study highlights the role of preoperative SPECT in modern knee surgery to obtain information about the loading pattern on different compartments of the knee. Despite the limited number of participants, the present study shows that a preoperative SPECT\/CT scan can help the treating surgeons to identify patients who may be at risk of inferior clinical outcome if an MOWHTO is considered, as an elevated BTU in the patellar region on preoperative SPECT\/CT appears to be a potential risk factor for postoperative pain and stiffness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06717-2","type":"journal-article","created":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T08:02:40Z","timestamp":1630828960000},"page":"397-406","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Increased patellar bone tracer uptake in preoperative SPECT\/CT before medial opening high tibial osteotomy correlates with inferior clinical outcome"],"prefix":"10.1002","volume":"30","author":[{"given":"B. L.","family":"Schelker","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"},{"name":"<!--<label>2<\/label>--> University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. S.","family":"Moret","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"},{"name":"<!--<label>2<\/label>--> University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Dogan","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"},{"name":"<!--<label>2<\/label>--> University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Amsler","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Amsler Consulting Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Rasch","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Institute of Radiology and Nuclear Medicine Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. W.","family":"H\u00fcgli","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Institute of Radiology and Nuclear Medicine Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4014-424X","authenticated-orcid":false,"given":"M. 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