Degree of axis correction in valgus high tibial osteotomy: proposal of an individualised approach

Abstract

The present paper introduces an individualized approach to adopt the degree of valgus correction in dependence of the underlying pathology. The area of interest on the tibial plateau lies in between the 50% and 65% coordinate on the tibial plateau, or in between a mean mFTA of 0.3° and 3.4° of valgus, respectively. Differences of the resulting mFTA between each area are small, and therefore a precise surgical technique is mandatory.

Surgical accuracy in high tibial osteotomy: coronal equivalence of computer navigation and gap measurement

“…intended correction has been tailored to each patient's individual problem [13], which may be influenced by surgical indication [13] and the degree of deformity or arthritis [29,30]. So a set target point (or range) for all patients, is inconsistent with this bespoke approach.…”

The UK Knee Osteotomy Registry (UKKOR)

“…Some surgeons aim for neutral, others match alignment to the healthy contralateral leg, some observe the degree of medial arthritis [30], and others consider the difference between compartments [31]. A bespoke correction for individual patients considering the degree of arthritis and some of the indications listed above has recently been proposed [32]. The reliability of planning methods has been quantified [33,34] but work on how this converts into surgical accuracy is ongoing.…”

Predicting the knee adduction moment after high tibial osteotomy in patients with medial knee osteoarthritis using dynamic simulations

“…These authors postulate that the ideal correction method is to align the mechanical axis to pass through a point 30 to 40% lateral to the tibia plateau midpoint. Some authors adapted Fujisawa's original recommendation taking into account the cartilage status of the medial and lateral knee compartments [5,8,9]. Although several variations for choosing the position of the weight-bearing axis exist [10,11], to date all methods used for planning a HTO are primarily based on radiographs obtained during a static standing position.…”