{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T23:28:17Z","timestamp":1776209297020,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study evaluated the clinical outcomes of medial open\u2010wedge high tibial osteotomy (MOWHTO) and bone marrow lesion (BML) scores and volumes. The hypotheses were that quantitative BML volume is more associated with clinical outcomes of MOWHTO than qualitative BML evaluations, and pre\u2010operative BML volume is associated with the improvement of clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent MOWHTO were retrospectively enrolled. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was recorded before the initial surgery and at plate removal surgery. Using pre\u2010operative short\u2010time inversion recovery magnetic resonance imaging, BMLs were evaluated using three qualitative scores, reflecting the maximum length, proportion, and intensity of BML. For quantification, BMLs of the femur and tibia were separately defined as lesions with a threshold greater than the mean signal intensity plus two standard deviations, using the corresponding lateral condyles as controls. The association between the KOOS scales and BML scores\/volume was evaluated using Spearman\u2019s correlation coefficient. Multivariate linear regression analyses for post\u2010operative KOOS scales were performed using the tibial BML volume as one of the four independent variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final analysis included 40\u00a0MOWHTO cases. Two qualitative BML scores correlated only with pre\u2010operative KOOS sports. Femoral and tibial BML volumes were correlated with post\u2010operative KOOS QOL (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.40, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and sports (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.02), respectively. Tibial BML volume was significantly correlated with all five delta KOOS scales (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.39\u20130.51, <jats:italic>p<\/jats:italic>\u2009=\u20090.01\u20130.001), however, femoral BML volume was only correlated with delta KOOS QOL (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.41, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). In multivariate analyses, tibial BML volume was a significant positive predictor for every post\u2010operative KOOS scale, while post\u2010operative % mechanical axis was also a positive significant variable, except post\u2010operative KOOS pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tibial BML volume was positively correlated with one post\u2010operative KOOS scale and all delta KOOS scales. A larger pre\u2010operative tibial BML and appropriate alignment correction were associated with a better post\u2010operative KOOS scales. Pre\u2010operative large BML had no negative influence on post\u2010operative clinical outcomes; hence, surgeons need not hesitate to perform MOWHTO in patients with large BMLs in the medial condyles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Retrospective case series, Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07134-9","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:02:21Z","timestamp":1661731341000},"page":"3646-3654","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Larger bone marrow lesion volume before medial open\u2010wedge high tibial osteotomy correlates with better improvement of clinical scores in patients with knee osteoarthritis"],"prefix":"10.1002","volume":"31","author":[{"given":"Taisuke","family":"Yabe","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Graduate School of Medicine Kyoto University 54 Shogoin\u2010Kawahara\u2010Cho, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8327-3826","authenticated-orcid":false,"given":"Kohei","family":"Nishitani","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Graduate School of Medicine Kyoto University 54 Shogoin\u2010Kawahara\u2010Cho, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeo","family":"Yoshida","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Graduate School of Medicine Kyoto University 54 Shogoin\u2010Kawahara\u2010Cho, Sakyo\u2010ku 606\u20108507 Kyoto 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June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"SK received a research grant from Olympus-Terumo Biomaterials Corp. outside of this study. Others declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the ethics committees of Kyoto University Hospital (R1970).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Because of the retrospective study design, informed consent was waived and opt-out was performed.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}