{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T04:24:19Z","timestamp":1793766259572,"version":"4.6.1"},"reference-count":32,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In carefully selected patients with an arthritic valgus knee, distal femoral osteotomy (DFO) can improve symptoms at medium- to long-term follow-up, reducing osteoarthritis progression. To date, there is no clear evidence in the current literature regarding the role of postoperative joint line obliquity (JLO) in valgus deformity correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess the clinical and radiological outcomes of medial closing-wedge DFO (MCW-DFO) for the treatment of valgus knees, considering both tibial- and femoral-based deformities, as well as to verify the efficacy and safety of MCW-DFO according to JLO boundaries (\u22644\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on a cohort of patients with valgus knees. Patients were divided into 2 groups: femoral-based valgus (FB-V) and tibial-based valgus (TB-V). Knee radiographs were collected before surgery and at the last follow-up. The clinical outcome was evaluated through several validated scores (International Knee Documentation Committee, Knee Society Score, Knee injury and Osteoarthritis Outcome Score, Tegner, Numeric Rating Scale, Crosby-Insall).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 30 patients (34 knees) with a mean age of 49.3 \u00b1 9.1 years were included in the study. The overall mean follow-up was 9.4 \u00b1 5.9 years. The mean preoperative hip-knee-ankle angle was 187.6\u00b0\u00b1 3.3\u00b0 (range, 181.5\u00b0-191\u00b0) and the postoperative angle was 180\u00b0\u00b1 3.1\u00b0 (range, 176\u00b0-185\u00b0). Most postoperative JLOs were within the safe zone of \u22644\u00b0 in both groups (the postoperative JLO was &gt;4\u00b0 in 4 patients in the TB-V group and 1 patient in the FB-V group), although FB-V knees exhibited significant superior JLO correction (postoperative JLO in the TB-V group: mean, 4.0\u00b0\u00b1 2.5\u00b0 [ P = .1]; postoperative JLO in the FB-V group: mean, 2.4\u00b0\u00b1 1.4\u00b0 [ P = .5]). Significant improvements in all clinical scores were observed in both groups ( P &lt; .01). Additionally, the severity of the osteoarthritis did not worsen at the last follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MCW-DFO is an effective procedure for treating pathological valgus knees, regardless of the site of the deformity. Both FB-V and TB-V groups showed comparable improvements in the clinical scores, development of osteoarthritis, and the restoration of a neutral mechanical axis. Notably, FB-V knees achieved more JLO correction compared with the TB-V ones.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241262437","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T01:40:15Z","timestamp":1723426815000},"page":"2524-2531","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes of Medial Closing-Wedge Distal Femoral Osteotomy for Femoral- and Tibial-Based Valgus Deformity"],"prefix":"10.1177","volume":"52","author":[{"given":"Alessio","family":"Maione","sequence":"first","affiliation":[{"name":"U.O.C. 1st Orthopedic Clinic, ASST Gaetano Pini-CTO, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Ricci","sequence":"additional","affiliation":[{"name":"IRCCS Galeazzi \u2013 Sant\u2019Ambrogio Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Calanna","sequence":"additional","affiliation":[{"name":"U.O.C. 1st Orthopedic Clinic, ASST Gaetano Pini-CTO, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo D.","family":"Parmigiani","sequence":"additional","affiliation":[{"name":"U.O.C. 1st Orthopedic Clinic, ASST Gaetano Pini-CTO, Milan, Italy"},{"name":"Residency Program in Orhopedics and Traumatology, University Of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Menon","sequence":"additional","affiliation":[{"name":"U.O.C. 1st Orthopedic Clinic, ASST Gaetano Pini-CTO, Milan, Italy"},{"name":"Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, University Of Milan, Milan, Italy"},{"name":"Graduate School Of Health Statistics And Biometrics, Department Of Clinical And Community Sciences, University Of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Usellini","sequence":"additional","affiliation":[{"name":"U.O.C. 1st Orthopedic Clinic, ASST Gaetano Pini-CTO, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro S.","family":"Randelli","sequence":"additional","affiliation":[{"name":"U.O.C. 1st Orthopedic Clinic, ASST Gaetano Pini-CTO, Milan, Italy"},{"name":"Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, University Of Milan, Milan, Italy"},{"name":"Research Center for Adult and Pediatric Rheumatic Diseases (RECAP-RD), Department of Biomedical Sciences for Health, University Of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Berruto","sequence":"additional","affiliation":[{"name":"U.O.C. 1st Orthopedic Clinic, ASST Gaetano Pini-CTO, Milan, 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