{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:35:27Z","timestamp":1792733727805,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate the permissible joint\u2010line obliquity (JLO) based on radiologic and clinical outcomes with midterm follow\u2010up after medial open\u2010wedge high tibial osteotomy (MOWHTO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who had undergone MOWHTO from March 2014 to May 2016 were retrospectively evaluated. They were divided into 4 groups based on JLO as represented by postoperative medial proximal tibial angle (MPTA). Radiologic parameters including MPTA, joint\u2010line orientation angle (JLOA), joint\u2010line convergence angle (JLCA), posterior tibial slope, weightbearing line ratio (WBLR), and coronal translation were analyzed. Clinical outcomes were evaluated with American Knee Society Score (AKSS), Western Ontario and McMaster University Index, and short\u2010form 36 health survey (SF\u201036). The changes between preoperation and final follow\u2010up in JLOA and MPTA were defined as \u0394JLOA and \u0394MPTA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 135 knees were finally included (MPTA \u226490.32\u00b0 as group I; 90.33\u00b0 to 92.62\u00b0 as group II; 92.74\u00b0 to 95.22\u00b0 as group III; and\u00a0\u226595.23\u00b0 as group IV). The last follow\u2010up MPTA, JLOA, and JLCA values were different between the groups (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001, and\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .015, respectively). WBLR and JLOA positively correlated with MPTA; however, WBLR showed an abrupt increase at MPTA &gt;96.5\u00b0, and the JLOA distribution tended to be greater than the regression line at MPTA &gt;96\u00b0. Moreover, \u0394JLOA was not as large as \u0394MPTA. The percentage of patients attaining a minimal clinically important difference was significantly lower in the\u00a0AKSS\u2010functional score and SF\u201036 physical component summary in group IV (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.008 and 0.021, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The JLOA did not change as much as the MPTA, but an MPTA &gt;95.2\u00b0 abruptly increased the JLOA and valgus overcorrection after MOWHTO. Poor clinical outcomes were more evident in excessive MPTA (&gt;95.2\u00b0) than in mildly undercorrected or properly corrected MPTA (&lt;95.2\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>III, retrospective cohort study<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2021.11.004","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T00:07:16Z","timestamp":1636848436000},"page":"1904-1915","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":58,"title":["Excessively Increased Joint\u2010Line Obliquity After Medial Opening\u2010Wedge High Tibial Osteotomy Is Associated With Inferior Radiologic and Clinical Outcomes: What Is Permissible Joint\u2010Line Obliquity"],"prefix":"10.1002","volume":"38","author":[{"given":"Joo Sung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Kyu","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Gyeol","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Won","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Bae","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Jae","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Seuk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South 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