Clinical Research Directory

Radiological Comparison Between Single-Leg and Double-Leg Stance in the Assessment of Genu Varum: Pre- and Postoperative Evaluation and Functional Outcomes

Genu varum, commonly known as bow-legged deformity, is characterized by an outward angulation of the knee joint that disrupts normal lower limb alignment and weight distribution(1,2). This condition alters the mechanical axis of the limb, often increasing medial compartment loading, which can accelerate degenerative joint changes and pain. Radiographic assessment plays a central role in quantifying the deformity, typically measured through parameters such as the hip-knee-ankle (HKA) angle, mechanical axis deviation (MAD), and medial proximal tibial angle (MPTA)(1,2). Weight-bearing posture during imaging significantly influences these alignment parameters. Several studies have demonstrated that single-leg stance radiographs produce more physiologically representative alignment measurements than double-leg stance, since the single-leg condition better simulates natural load distribution and joint reaction forces during locomotion(3,4). The single-leg stance increases joint compression and reveals hidden malalignments that may be masked in double-leg or non-weight-bearing positions. Consequently, preoperative evaluations based solely on double-leg stance may underestimate the severity of genu varum deformity(3,4). Surgical correction, through techniques such as high tibial osteotomy or guided growth, aims to restore the mechanical axis to a near-neutral position, improving load symmetry and delaying degenerative changes(4,5). Postoperative evaluation is essential for monitoring realignment success and predicting functional recovery, which often involves comparing radiological correction with clinical outcomes such as range of motion, pain reduction, and activity resumption. However, the correspondence between radiographic correction measured under different stance conditions and postoperative function remains poorly defined(6,7). Recent evidence suggests that patients assessed preoperatively under single-leg stance conditions may have more accurate predictions of postoperative alignment and function than those evaluated under double-leg stance (5,6). Furthermore, differences between stance types may influence surgical planning decisions, including the degree of correction targeted and the fixation technique used. Functional outcomes after genu varum correction depend not only on bony realignment but also on balanced muscular forces, proprioception, and joint stability - factors more dynamically engaged in single-leg stance evaluation(7,8). Despite increasing recognition of weight-bearing differences in radiological evaluation, limited research directly compares single-leg versus double-leg stance assessment for genu varum across preoperative and postoperative stages. Establishing which stance provides a more reliable correlation with functional outcomes could refine surgical planning, enhance rehabilitation monitoring, and standardize postoperative evaluation protocols for improved patient outcomes.

Kinematic vs Mechanical Alignment in High Tibial Osteotomy

To compare between kinematic and mechanichal alignment after High Tibial Osteotomy (clinically and radiologically)

TO Plate Fixation vs. External Fixator Comparison (HTO Plate vs. ExFix Study)

This study aims to compare the efficacy, accuracy, and functional outcomes of two different surgical stabilization techniques for medial opening wedge high tibial osteotomy (HTO) in patients with varus deformity and medial compartment osteoarthritis. Patients will be prospectively randomized into two groups: Group 1 (Plate Fixation) will receive acute (single-stage) correction and stabilization with a medial HTO locking plate. Group 2 (HTO External Fixator) will receive stabilization using a self-adjusting HTO external fixator, followed by gradual correction (hemicallotasis/distraction) starting 7 days post-operatively. The study will evaluate radiological correction, functional improvement (using the Oxford Knee Score), and complication rates over a 12-month follow-up period.

Effects of Hip Blood Flow Restriction and Shockwave Therapy on Q-Angle and Plantar Pressure in Adults With Genu Varum

This study aims to investigate the effects of gluteus medius-focused blood flow restriction (BFR) training, with or without the addition of radial shockwave therapy, on lower limb alignment in adults with genu varum. The study uses a crossover design and evaluates changes in Q-angle(Quadriceps-angle) and plantar pressure as primary outcomes. All interventions are non-invasive and supervised, and the goal is to identify effective therapeutic strategies to improve biomechanical alignment in individuals with bowed legs.

Plate vs. Screw for Guided Growth in Coronal Knee Deformities

The goal of this clinical trial is to compare two surgical techniques, Tension Band Plate (TBP) and Percutaneous Epiphysiodesis by Transphyseal Screw (PETS), in children with coronal angular knee deformities. The main questions it aims to answer are: * Which technique provides better correction of coronal knee deformities? * Are there differences in complication rates or recovery times between TBP and PETS? Participants will: * Undergo either TBP or PETS surgery for knee deformity correction. * Attend follow-up visits for radiographic and clinical evaluations. Researchers will compare TBP and PETS groups to see if one method leads to better deformity correction and fewer complications.

Effect of Lateral Wedged Insoles With Subtalar Strapping on Genu Varum With Medial Compartment Knee Pain

The purpose of the study is to investigate the effect of lateral wedged insoles with subtalar strapping in genu varum with medial compartment knee pain on: 1. Space between knees (measured by vernier calipers) 2. Degree of genu varum deformity (Femorotibial angle (FTA)) measured on long film weight bearing x-ray) 3. Pain level (Measured by VAS) 4. Hind foot angle (measured by long axial hindfoot alignment view) 5. Functional outcome (measured by the lower extremity function scale) 6. Functional performance (measured by the 6 minute walk test)

Hemiepiphysiodesis by Eight Plate Versus Osteotomy in the Management of Pediatric Coronal Knee Deformities

Coronal angular deformities of lower limb in children are a common finding in pediatric orthopedic surgery.These angular deformities can be idiopathic in origin, or they can emerge secondary to congenital and acquired abnormalities. Persistent coronal plane deformities around knee (genu varum/valgum) could lead to meniscal tears, collateral ligament laxity, cartilage degeneration, and early osteoarthritis due to gradual mechanical axis disruption

Adductor Ratio in Severe Varus Gonarthrosis

The restoration of the joint line (JL) is essential for the proper functioning of Total Knee Arthroplasty (TKA). The exact position of JL can be determined using anatomical landmarks such as femoral condylar width (TEW), tibial tubercle, fibular head, and adductor tubercle during preoperative planning or intraoperatively. However, in cases of severe varus deformity in Type M gonarthrosis, it is unknown which method is most suitable for accurately determining the precise JL position. The aim of this study is to identify the most appropriate method for determining the JL position in Type M gonarthrosis. To achieve this goal, two groups of patients with Type 1A and Type M gonarthrosis will be compared by measuring preoperative values and comparing them with intraoperative reference values.