A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and Implications
Opening-wedge high tibial osteotomy (OWHTO) is a well-documented surgical intervention for medial compartment osteoarthritis with knee varus deformity. The optimal alignment, specifically targeting the Fujisawa point and managing a negative weight-bearing line ratio (WBLR), remains a challenge, espe...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-10-01
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| Series: | Formosan Journal of Musculoskeletal Disorders |
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| Online Access: | https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00025 |
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| author | Chang-Lin Wu Chen-Heng Hsu Chieh-An Chung Yi-Sheng Chan Kuo-Yao Hsu Alvin Chao-Yu Chen Joe Chih-Hao Chiu Cheng-Pang Yang |
| author_facet | Chang-Lin Wu Chen-Heng Hsu Chieh-An Chung Yi-Sheng Chan Kuo-Yao Hsu Alvin Chao-Yu Chen Joe Chih-Hao Chiu Cheng-Pang Yang |
| author_sort | Chang-Lin Wu |
| collection | DOAJ |
| description | Opening-wedge high tibial osteotomy (OWHTO) is a well-documented surgical intervention for medial compartment osteoarthritis with knee varus deformity. The optimal alignment, specifically targeting the Fujisawa point and managing a negative weight-bearing line ratio (WBLR), remains a challenge, especially with severe varus deformities. We detail the case of a 46-year-old Asian male medical staff member with a negative WBLR and severe varus deformity due to a combination of traumatic events and underlying osteoarthritis. Despite the existing debate around alignment targets, our patient underwent OWHTO alongside a segmental meniscus transplant using autologous tendon graft. One-year postoperative assessments showed improved alignment, a negative McMurray test result, and enhanced patient-reported outcomes. This case underscores the potential of integrating OWHTO and medial meniscus autograft transplantation in patients with challenging presentations, such as a negative WBLR. Large corrections in such patients’ risk enhancing the medial proximal tibial angle leading to altered knee dynamics. Our approach demonstrates the viability of a concurrent meniscus transplant with a focus on neutral alignment, aiming to mitigate risks associated with overcorrection. Combining OWHTO with meniscus autograft transplantation can be a feasible solution for complex cases presenting with negative WBLR, offering improved patient outcomes and function at 6-month follow-up. Further research is needed to validate these findings in larger patient cohorts. |
| format | Article |
| id | doaj-art-a154eeee435044fba5489d3fd2ba0d1e |
| institution | OA Journals |
| issn | 2210-7940 2210-7959 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Formosan Journal of Musculoskeletal Disorders |
| spelling | doaj-art-a154eeee435044fba5489d3fd2ba0d1e2025-08-20T02:16:34ZengWolters Kluwer Medknow PublicationsFormosan Journal of Musculoskeletal Disorders2210-79402210-79592024-10-0115416016510.4103/fjmd.FJMD-D-23-00025A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and ImplicationsChang-Lin WuChen-Heng HsuChieh-An ChungYi-Sheng ChanKuo-Yao HsuAlvin Chao-Yu ChenJoe Chih-Hao ChiuCheng-Pang YangOpening-wedge high tibial osteotomy (OWHTO) is a well-documented surgical intervention for medial compartment osteoarthritis with knee varus deformity. The optimal alignment, specifically targeting the Fujisawa point and managing a negative weight-bearing line ratio (WBLR), remains a challenge, especially with severe varus deformities. We detail the case of a 46-year-old Asian male medical staff member with a negative WBLR and severe varus deformity due to a combination of traumatic events and underlying osteoarthritis. Despite the existing debate around alignment targets, our patient underwent OWHTO alongside a segmental meniscus transplant using autologous tendon graft. One-year postoperative assessments showed improved alignment, a negative McMurray test result, and enhanced patient-reported outcomes. This case underscores the potential of integrating OWHTO and medial meniscus autograft transplantation in patients with challenging presentations, such as a negative WBLR. Large corrections in such patients’ risk enhancing the medial proximal tibial angle leading to altered knee dynamics. Our approach demonstrates the viability of a concurrent meniscus transplant with a focus on neutral alignment, aiming to mitigate risks associated with overcorrection. Combining OWHTO with meniscus autograft transplantation can be a feasible solution for complex cases presenting with negative WBLR, offering improved patient outcomes and function at 6-month follow-up. Further research is needed to validate these findings in larger patient cohorts.https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00025high tibial osteotomymeniscus autograft transplantationweight-bearing line ratio |
| spellingShingle | Chang-Lin Wu Chen-Heng Hsu Chieh-An Chung Yi-Sheng Chan Kuo-Yao Hsu Alvin Chao-Yu Chen Joe Chih-Hao Chiu Cheng-Pang Yang A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and Implications Formosan Journal of Musculoskeletal Disorders high tibial osteotomy meniscus autograft transplantation weight-bearing line ratio |
| title | A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and Implications |
| title_full | A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and Implications |
| title_fullStr | A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and Implications |
| title_full_unstemmed | A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and Implications |
| title_short | A Unique Case of Negative Weight-bearing Line Ratio in a Young Male Adult: Insights and Implications |
| title_sort | unique case of negative weight bearing line ratio in a young male adult insights and implications |
| topic | high tibial osteotomy meniscus autograft transplantation weight-bearing line ratio |
| url | https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00025 |
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