{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:38:28Z","timestamp":1791538708009,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100002632","name":"Hallym University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002632","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015028","name":"Kangdong Sacred Heart Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.fr","clinicalkey.jp","arthroscopyjournal.org","clinicalkey.es","clinicalkey.com.au","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the incidence of implant\u2010related pain after medial opening wedge high tibial osteotomy (MOWHTO) using a locking plate, to determine whether implant removal provides pain relief and functional improvement, and to evaluate bone healing and loss of correction after implant removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between March 2014 and September 2017, MOWHTO was performed without bone graft. The inclusion criteria were patients who underwent implant removal after MOWHTO and were followed up for a minimum of 2 years. Patients were evaluated for implant removal 1 and 2 years after surgery. Clinical and functional evaluations were conducted to investigate implant\u2010related pain using the visual analog scale, Lysholm score, and Tegner score. The radiographic indices measured were the gap\u2010filling rate, weightbearing line (WBL) ratio, hip\u2010knee\u2010ankle angle (HKAA), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 55 patients were enrolled. Fifty\u2010one (92.7%) patients experienced implant\u2010related pain prior to implant removal, with 43 and 8 patients reporting mild pain and moderate pain, respectively. At 1 and 2 years after implant removal, mild pain occurred in 6 (10.9%) and 5 (9.1%) patients, respectively. The remaining patients reported no implant\u2010related pain. Prior to implant removal and 1 year after implant removal, the Lysholm score improved from 77.0 \u00b1 5.6 to 86.8 \u00b1 5.7 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and the Tegner score improved from 3.3 \u00b1 1.2 to 3.9 \u00b1 1.3 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). The mean gap\u2010filling rate was 84.4% \u00b1 9.6% at implant removal, and it significantly increased to 93.7% \u00b1 5.4% and 97.4% \u00b1 2.6% at 1 and 2 years after implant removal, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). For the WBL ratio, HKAA, MPTA, and PTSA, no statistically significant differences were found after implant removal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of implant\u2010related pain after MOWHTO using the medial proximal tibial locking plate was high. Implant removal provides pain relief and functional improvement (met minimal clinically important differences). Even after implant removal, bone healing progressed gradually without a loss of correction in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2023.10.044","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T15:18:28Z","timestamp":1699456708000},"page":"1837-1844","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"title":["Implant Removal After Medial Opening Wedge High Tibial Osteotomy Provides Implant\u2010Related Pain Relief and Functional Improvement"],"prefix":"10.1002","volume":"40","author":[{"given":"Hyobeom","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Kangdong Sacred Heart Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u2010Sun","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung\u2010Yup","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Kangdong Sacred Heart Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young\u2010Heon","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Kangdong Sacred Heart Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young\u2010Jin","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeehyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul Sacred Heart General Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si Young","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4297-5"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3850-y"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43019-022-00170-2"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.07.018"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43019-023-00198-y"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.08.012"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06506-x"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-009-0902-2"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2015.09.015"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1681065"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06199-8"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05615-y"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.12.021"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2762-y"},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2010.05.006"},{"key":"e_1_2_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2018.05.013"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-009-0723-3"},{"key":"e_1_2_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.01.008"},{"key":"e_1_2_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.12.020"},{"key":"e_1_2_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2015.09.018"},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5334-3"},{"key":"e_1_2_3_23_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00188"},{"key":"e_1_2_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-014-2442-7"},{"key":"e_1_2_3_25_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.18.034"},{"key":"e_1_2_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.08.028"},{"key":"e_1_2_3_27_2","first-page":"195","article-title":"Evaluation of methods for radiographic measurement of the tibial slope. A study of 83 healthy knees [in French]","volume":"82","author":"Brazier J.","year":"1996","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"e_1_2_3_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3730-5"},{"key":"e_1_2_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.02.020"},{"key":"e_1_2_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2003.09.025"},{"key":"e_1_2_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.04.018"},{"key":"e_1_2_3_32_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00705"},{"key":"e_1_2_3_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211002289"},{"key":"e_1_2_3_34_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B12.21198"},{"key":"e_1_2_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.07.024"},{"key":"e_1_2_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2017.06.002"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323009088?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323009088?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2023.10.044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2023.10.044","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2023.10.044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:07:41Z","timestamp":1773565661000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2023.10.044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,8]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1016\/j.arthro.2023.10.044"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2023.10.044","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Implant Removal After Medial Opening Wedge High Tibial Osteotomy Provides Implant-Related Pain Relief and Functional Improvement","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2023.10.044","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}