{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:25:40Z","timestamp":1789997140883,"version":"4.0.1"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Changes in the coronal, sagittal, and axial alignments during supra\u2010tubercular biplanar medial opening wedge high tibial osteotomy (STB\u2010MOWHTO) may have different influences on tibial tubercle\u2013trochlear groove (TT\u2013TG) distance, but few pieces of literature have addressed this specific concern. We aimed to analyze the impacts of changes in alignments in different planes during STB\u2010MOWHTO on the TT\u2013TG distance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent STB\u2010MOWHTO for varus knee deformity at our hospital were reviewed retrospectively from January 2020 to December 2022. Radiographic parameters, including opening width (OW), distal tibial rotation (DTR), posterior tibial slope (PTS), and TT\u2013TG distance, were assessed before operation and directly postoperatively. Multivariate mixed linear regression analyses were employed to investigate the relationships between OW, the changes in DTR, PTS, and TT\u2013TG distance. Restricted cubic spline curve fitting and threshold effects were used to assess potential non\u2010linear relationships between the independent variables and changes in TT\u2013TG distance. Stratification analysis was conducted to assess the stability of the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and two knee joints from 66 patients were included. TT\u2013TG distance change was positively correlated with OW (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.551, 95% CI: 0.340, 0.762, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and DTR change (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.284, 95% CI: 0.196, 0.371, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Restricted cubic spline curve fitting and threshold effect analyses did not identify any non\u2010linear relationships or inflection points between OW, DTR change, and TT\u2013TG distance change. Further, stratification analysis of DTR in various directions confirmed the stability of the linear relationship between DTR change and TT\u2013TG distance change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The TT\u2013TG distance change exhibited a positively correlated linear relationship with OW and DTR change during STB\u2010MOWHTO. For every 1\u2009mm increase in OW, TT\u2013TG distance increased by an average of 0.551\u2009mm. For every 1\u00b0 increase in DTR, TT\u2013TG distance increased by an average of 0.284\u2009mm.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> Level III.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70119","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T03:00:26Z","timestamp":1755658826000},"page":"2844-2850","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Influence of Alignment Changes in Different Planes During Supra\u2010Tubercular Biplanar Medial Opening Wedge High Tibial Osteotomy on Tibial Tubercle\u2013Trochlear Groove Distance"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2550-9551","authenticated-orcid":false,"given":"Lizhong","family":"Jing","sequence":"first","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meifeng","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Yingjisha County People's Hospital  Kashgar China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiushan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shandong Provincial Hospital Shandong University  Jinan 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