{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:01:54Z","timestamp":1789970514659,"version":"4.0.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["252102310082"],"award-info":[{"award-number":["252102310082"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["242102310025"],"award-info":[{"award-number":["242102310025"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate whether excessive tibial valgus, defined as a medial proximal tibial angle (MPTA)\u2009&amp;gt;\u200995\u00b0 at the final follow-up, was associated with worse 5-year clinical outcomes after medial opening-wedge high tibial osteotomy (MOWHTO) in patients with Kellgren-Lawrence (K-L) grade IV medial compartment knee osteoarthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 165 knees with K-L grade IV medial compartment knee osteoarthritis that underwent MOWHTO. Knees were classified according to the MPTA measured on weight-bearing full-length radiographs at the final follow-up as MPTA &amp;gt;95\u00b0 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200981) or MPTA \u226495\u00b0 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200984). The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at the final follow-up. Secondary outcomes included the Lysholm score, visual analogue scale (VAS) for pain, knee range of motion (ROM), and radiographic parameters. Between-group changes were compared, and clinical outcomes were further evaluated using baseline-adjusted analysis of covariance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean follow-up duration was 64.49\u2009\u00b1\u20093.60 months. WOMAC, Lysholm, VAS, and ROM improved significantly from baseline to the final follow-up in the overall cohort (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). At the final follow-up, WOMAC, Lysholm, VAS, and ROM did not differ significantly between the MPTA &amp;gt;95\u00b0 and MPTA \u226495\u00b0 groups. Although changes in MPTA and hip\u2013knee\u2013ankle angle were greater in the MPTA &amp;gt;95\u00b0 group, no significant between-group differences were observed in changes in WOMAC, Lysholm, VAS, or ROM after Holm adjustment. In baseline-adjusted analyses, an MPTA &amp;gt;95\u00b0 was not significantly associated with WOMAC (adjusted mean difference, \u22120.16; 95% CI, \u22125.42 to 5.11;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.953), Lysholm (0.24; 95% CI, \u22123.22 to 3.69;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.893), VAS (\u22120.07; 95% CI, \u22120.39 to 0.24;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.645), or ROM (\u22121.52\u00b0; 95% CI, \u22124.44 to 1.39;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.306).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with K-L grade IV medial compartment knee osteoarthritis treated with MOWHTO, an MPTA &amp;gt;95\u00b0 at the final follow-up was not significantly associated with worse 5-year clinical outcomes. These findings suggest that the 95\u00b0 MPTA threshold should not be interpreted in isolation as a determinant of clinical outcome; however, they do not define an optimal correction target or support deliberate overcorrection beyond 95\u00b0.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1946486","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:34:56Z","timestamp":1789968896000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Excessive tibial valgus was not associated with worse 5-year clinical outcomes after medial opening-wedge high tibial osteotomy for advanced knee osteoarthritis: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yisan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Henan University of Chinese Medicine Henan Provincial Hospital of TCM","place":["Zhengzhou, 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