{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:19:21Z","timestamp":1788956361970,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172466"],"award-info":[{"award-number":["82172466"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["91949203)"],"award-info":[{"award-number":["91949203)"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,1]]},"abstract":"\n Objective<\/jats:title>\n Uneven settlement of the proximal tibia significantly contributes to the onset and progression of medial compartment knee OA; however, the specific location and variations of proximal tibial deformity remain unclear. Therefore, this study aimed to explore the effects of the anatomic morphology of different tibial regions on proximal tibial vara and proximal tibial microstructural changes with age in both sexes to reveal the pattern of uneven settlement of the proximal tibia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this retrospective study, we reviewed the radiographs of 414 patients (789 legs) between May and September 2021. The medial proximal tibial angle (MPTA) and four anatomic angles of the tibia (i.e., the tibial plateau\u2010epiphyseal line [PT\u2010EL] angle, epiphyseal line\u2010tibial platform [EL\u2010PF] angle, epiphyseal axis inclination angle [EAIA], and subepiphyseal axis inclination angle [SAIA]) were measured. The effect of each angle on MPTA and their changes with age in both sexes were investigated using Pearson's correlation coefficient and multiple linear regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In females, PT\u2010EL angle, EL\u2010PF angle, and SAIA negatively correlated with MPTA (\n r<\/jats:italic>\n \u00a0=\u00a0\u22120.325, \u22120.246, and \u22120.502;\n p<\/jats:italic>\n \u2009<\u20090.05), and EAIA positively correlated with MPTA (\n r<\/jats:italic>\n \u00a0=\u00a00.099,\n p<\/jats:italic>\n \u2009<\u20090.05). Regression analysis showed that the correlations between MPTA and PT\u2010EL angle, EL\u2010PF angle, and SAIA were significant (\n \u03b2<\/jats:italic>\n \u00a0=\u00a0\u22121.003, \u22120.013, and \u22120.971; adjusted\n R<\/jats:italic>\n 2<\/jats:sup>\n \u00a0=\u00a00.979). Furthermore, MPTA negatively correlated with age (\n r<\/jats:italic>\n \u00a0=\u00a0\u22120.202,\n p<\/jats:italic>\n \u2009<\u20090.05); PT\u2010EL angle and EAIA positively correlated with age (\n r<\/jats:italic>\n \u00a0=\u00a00.237 and 0.142,\n p<\/jats:italic>\n \u2009<\u20090.05). Regression analysis showed that only the correlation between PT\u2010EL angle and age was significant (\n \u03b2<\/jats:italic>\n \u00a0=\u00a05.635,\n p<\/jats:italic>\n \u2009<\u20090.05). In males, PT\u2010EL angle, EL\u2010PF angle, and SAIA negatively correlated with MPTA (\n r<\/jats:italic>\n \u00a0=\u00a0\u22120.270, \u22120.267, and \u22120.533;\n p<\/jats:italic>\n \u2009<\u20090.05), and EAIA positively correlated with MPTA (\n r<\/jats:italic>\n \u00a0=\u00a00.135,\n p<\/jats:italic>\n \u2009<\u20090.05). Regression analysis showed that the correlations between MPTA and PT\u2010EL angle, EL\u2010PF angle, and SAIA were significant (\n \u03b2<\/jats:italic>\n \u00a0=\u00a0\u22120.992, \u22120.017, and \u22120.958; adjusted\n R<\/jats:italic>\n 2<\/jats:sup>\n \u00a0=\u00a00.970). However, there was no significant correlation between age and any of the measured angles (\n p<\/jats:italic>\n \u2009>\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Proximal tibial vara is affected by the anatomic morphology of the epiphyseal and subepiphyseal regions. In females, the uneven settlement of the epiphysis progresses with age and may be responsible for dynamic varus deformity of the proximal tibia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.13632","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T04:13:50Z","timestamp":1671077630000},"page":"239-246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anatomical Imaging Study on Uneven Settlement of the Proximal Tibia"],"prefix":"10.1111","volume":"15","author":[{"given":"Zhijie","family":"Wang","sequence":"first","affiliation":[{"name":"Hebei Medical University Third Affiliated Hospital Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zheng","sequence":"additional","affiliation":[{"name":"Hebei Medical University Third Affiliated Hospital Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Decheng","family":"Meng","sequence":"additional","affiliation":[{"name":"Hebei Medical University Third Affiliated Hospital Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Handi","family":"Li","sequence":"additional","affiliation":[{"name":"Hebei Medical University Third Affiliated Hospital Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenni","family":"Ji","sequence":"additional","affiliation":[{"name":"Hebei Medical University Third Affiliated Hospital Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2401-5314","authenticated-orcid":false,"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"Hebei Medical University Third Affiliated Hospital Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000479"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16234701"},{"issue":"120","key":"e_1_2_9_4_1","first-page":"3","article-title":"Osteoarthritis is a serious disease","volume":"37","author":"Hawker GA","year":"2019","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2013.11.024"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191045"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24151"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24340"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05840-5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12529"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-3146-0"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12437"},{"key":"e_1_2_9_13_1","first-page":"48","article-title":"Mechanical axis deviation of the lower limbs. 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