Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (3): 570-576.doi: 10.12307/2025.909

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High tibial osteotomy on a single plane: femorofibular angle as a reference marker for mechanical axis correction

Li Xiaomin1, Tian Xiangdong2, Wang Chaolu1   

  1. 1Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China; 2Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China

  • Received:2024-09-04 Accepted:2024-11-19 Online:2026-01-28 Published:2025-07-03
  • Contact: Corresponding author: Tian Xiangdong, Chief physician, Doctoral supervisor, Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China Corresponding author: Wang Chaolu, Chief physician, Doctoral supervisor, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
  • About author:Li Xiaomin, Doctoral candidate, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
  • Supported by:
    Basic Research Business Expenses Project of Beijing University of Chinese Medicine, No. 2023-JYB-JBZD-026 (to TXD); Chinese Society of Traditional Chinese Medicine Information Research Project, No. CACMS-KY-2023008 (to WCL)

Abstract: BACKGROUND: The femorofibular angle is a commonly used reference angle for mechanical axis correction in high tibial osteotomy on a single plane, but there has been no in-depth study on the application of this angle in high tibial osteotomy on a single plane. 
OBJECTIVE: To explore the application effect of the femorofibular angle as a reference for mechanical axis correction in high tibial osteotomy on a single plane. 
METHODS: A retrospective analysis was conducted on 64 cases of knee osteoarthritis patients who underwent high tibial osteotomy on a single plane at Third Affiliated Hospital of Beijing University of Chinese Medicine from January 2023 to January 2024. The patients were grouped according to the intraoperative mechanical axis correction reference method. The observation group consisted of 32 cases, which used the femorofibular angle as a reference for mechanical axis correction during surgery. The control group consisted of 32 cases, which used electrocautery line measurement as a reference for mechanical axis correction during surgery. Both groups received the same perioperative treatment and management. The lower limb mechanical axis ratio, hip-knee-ankle angle, proximal medial tibial angle, and femorofibular angle were recorded before and after surgery to assess changes in the lower limb mechanical state. The operation time and number of fluoroscopies were recorded. The visual analog scale score and Lysholm score for pain and knee function were recorded before surgery and at 1 and 3 months after surgery to evaluate changes in knee pain and function. 
RESULTS AND CONCLUSION: (1) All patients completed the treatment and follow-up, and no serious adverse events occurred. (2) Before surgery, there was no statistically significant difference in the lower limb mechanical axis ratio, proximal medial tibial angle, hip-knee-ankle angle, and femorofibular angle between the two groups (P > 0.05). At 3 months after surgery, the lower limb mechanical axis ratio, proximal medial tibial angle, hip-knee-ankle angle, and femorofibular angle were significantly improved in both groups compared to before surgery, with statistically significant differences (P < 0.05). There was no significant difference between the two groups (P > 0.05). (3) During surgery, the operation time and number of fluoroscopies in the observation group were less than those in the control group, with statistically significant differences (P < 0.05). (4) At each follow-up point before and after surgery, there was no statistically significant difference in the visual analog scale score and Lysholm score between the two groups (P > 0.05). With the passage of time after surgery, the visual analog scale score and Lysholm score in both groups were significantly improved compared to before surgery (P < 0.05). (5) It is suggested that the application of the femorofibular angle as a reference for mechanical axis correction in high tibial osteotomy on a single plane can accurately locate the range of lower limb mechanical axis correction, is simple and reliable, and reduces the number of fluoroscopies and operation time compared to traditional electrocautery line measurement.


Key words: high tibial osteotomy on a single plane, knee osteoarthritis, femorofibular angle, mechanical axis correction, follow-up, orthopedic implants

CLC Number: