Association between clinical symptoms and lateral thrust 12 months after high tibial osteotomy.
Toshiki Azuma, Kentaro Sasaki, Ayako Yokota and 8 others
PMID 37266363WHAT IT FOUND
Patients with a lateral thrust of 3.1 degrees or more had worse knee function scores 12 months after surgery.
To avoid this abnormal knee motion, the hip-knee-ankle angle should be corrected to at least 1.9 degrees of valgus.
Key findings
01A lateral thrust cut-off of 3.1 degrees was associated with poor Japanese Orthopaedic Association (JOA) scores.
02The hip-knee-ankle (HKA) angle cut-off value to prevent lateral thrust was -1.90 degrees (1.9 degrees valgus).
03Patients in the lateral thrust group had significantly higher knee adduction moments and knee varus angles during gait compared to those without lateral thrust.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study had a small sample size (54 patients). It was a cross-sectional design, so it cannot establish causality between lateral thrust and poor outcomes. Two different surgical techniques (medial opening wedge and hybrid closed wedge HTO) were included, which may affect gait parameters differently.
Declared interests
The authors declared no competing financial interests or personal relationships.
The easy way to misread this
Do not assume that achieving a standard 2°–4° valgus alignment guarantees the absence of lateral thrust or good function. The study suggests a specific threshold (1.9° valgus) is needed to prevent lateral thrust, but individual patient factors and surgical technique variations (opening vs. closed wedge) were not separated in the analysis.