High Tibial Open-Wedge Osteotomy – New Techniques and Early Results

Kolb, Werner; Guhlmann, Hanno; Windisch, Christoph; Kolb, Klaus

doi:10.5772/29838

Cited by 4 publications

(3 citation statements)

References 125 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No patient should be turned away from these operations solely because they are obese [Bonasia et al [17] Stephanie Floerkemeier et al] [14] . The open-wedge HTO approach produced better results in terms of functional scores than closed-wedge osteotomy in both early and late follow-up, requiring less time for fullweight bearing [Sanjay Agarwal et al, Kolb et al, Luites et al, 2009] [18,3,19] . The successful outcome of HTO can be maintained for more than 8 to 10 years delaying the need for conversion to TKA (Lee and Byun, 2012) (20) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Functional outcomes of high tibial osteotomy for symptomatic medial compartment osteoarthritis in middle-aged patients-both prospective and retrospective study in Indian population in the quaternary care center

Porammanavar,

et al. 2024

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

Background: High Tibial osteotomy is a surgical procedure to reposition the mechanical axis of a painful varus knee into a slightly valgus one, which minimizes joint tenderness and also decreases the rate of cartilage degeneration so the joint replacement surgery can be postponed. Materials & Methods: 500 patients were evaluated in the study. The study population included patients who underwent HTO at Manipal Hospital, Bangalore & those who came for follow-up after surgery during the period 2008 to 2017. An X-ray scanogram was done pre-operatively & post-operatively to assess the correction. Visual analogue score and Knee society score are used to evaluate the functional outcome. Results:The mean follow-up was 5 years. All the patients showed significant improvement in their postoperative scores. The mean age of the patients in our study at the time of surgery was 46.7 & sex distribution was 55.6% and 44.4% in Females and Males respectively. 44.4 % of the patients underwent left-sided HTO and 55.6 % of the patients were right HTO. The mean BMI was 25.5, the minimum was 19.3 & the maximum was 30.1. 47.2% of patients had normal BMI. The overall complication rate was 4.8% in our study. These complications include Delayed Union (2.4%), Stiffness of the knee (1.6%) and only 4 patients required revision to TKR (0.8%) at 5 years follow-up. The longest follow-up was 14 years and the minimum follow-up was 5 years. All these complications were manageable conservatively as all these complications were minor, and none of the patients required revision surgery. The visual analogue scale (VAS) was used to assess pain both preoperatively and postoperatively. The VAS and KSS scores significantly improved after surgery (p<0.001). The Knee Society score (knee score and functional score) at 5 years of follow-up was excellent in 22.8%, good in 55.6%, fair in 16.2% and poor in 5.4%. Conclusions: HTO alleviates pain, enhances activities of daily living, and improves the function and quality of life of patients suffering from symptomatic medial compartmental osteoarthritis of the knee. The success of HTO depends on the correct selection of patients, proper osteotomy, and precise surgical techniques. There are a few complications associated with this procedure, and it has a good success rate. It's an alternative procedure for Knee arthroplasty in symptomatic medial compartmental osteoarthritis patients and can delay the need for Knee arthroplasty which is the end procedure for Osteoarthritis knee.

show abstract

Section: Discussionmentioning

confidence: 99%

“…High tibial osteotomy was first described by Langenbeck in 1854. It is a very effective method to treat unicondylar osteoarthrosis [3] . Friedrich Pauwels and Paul Macquet defined the fundamental principles of osseous deformity correction in 1964 and 1976.…”

Section: Introductionmentioning

confidence: 99%

Functional outcomes of high tibial osteotomy for symptomatic medial compartment osteoarthritis in middle-aged patients-both prospective and retrospective study in Indian population in the quaternary care center

Porammanavar,

et al. 2024

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

show abstract

“…Alternatively, preoperative planning can be performed with long‐leg standing radiographs using the Miniaci technique [4, 7, 23, 25]. This technique yields a desired opening angle for the osteotomy, with calculations based on Fujisawa's assertion that optimal lower limb alignment is achieved when the mechanical axis passes through a point at 62.5 % of the tibial plateau's width, from medial to lateral, typically corresponding to the lateral tibial eminence [6–8, 10, 19, 23, 24, 27, 30]. However, perioperative assessment and application of the planned opening angle is challenging, as there is no reliable method or tool to accomplish this task [20].…”

Section: Introductionmentioning

confidence: 99%

Applicability of a modified angular correction measurement method for open-wedge high tibial osteotomy

Moore

Mychaltchouk

Lavoie

2016

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose The purpose of this study was to evaluate the clinical potential of a new measurement technique for open‐wedge high tibial osteotomy (HTO) based on the medial cortex opening (MCO) associated with the Miniaci preoperative planning technique. Methods A retrospective review of 97 cases of valgus‐producing HTO that were performed between 2008 and 2013, using the intra‐operative fluoroscopic mechanical axis technique, was carried out. The Miniaci‐based measurement technique was then used as a theoretical point of comparison with the intent to compare the disparity between postoperative and ideal lower extremity (LE) mechanical axis with the measured disparity between postoperative and Miniaci‐based planned MCO. Results A significant correlation was observed for the comparison of the disparity between postoperative and Miniaci‐based planned MCO and the disparity between postoperative and ideal LE mechanical axis (0.53, P = 0.001). This would suggest that the MCO associated with the Miniaci preoperative planning technique would have resulted in a better alignment had it been the chosen method to guide the amount of osteotomy opening. No significant correlation was observed between perioperative and postoperative LE mechanical axis (n.s.), the variable on which the current technique is based, confirming the poor reliability of the fluoroscopic mechanical axis technique. Conclusions This study suggests a more accurate and precise technique of realizing the appropriate angular correction when performing a HTO, which could lead to better clinical outcomes. Level of evidence III.

show abstract

Tibial slope and patellar height changes following high tibial osteotomy (a comparative study)

Osman

Yousef

El-Gebeily

et al. 2015

Eur Orthop Traumatol

View full text Add to dashboard Cite

High Tibial Open-Wedge Osteotomy – New Techniques and Early Results

Cited by 4 publications

References 125 publications

Functional outcomes of high tibial osteotomy for symptomatic medial compartment osteoarthritis in middle-aged patients-both prospective and retrospective study in Indian population in the quaternary care center

Functional outcomes of high tibial osteotomy for symptomatic medial compartment osteoarthritis in middle-aged patients-both prospective and retrospective study in Indian population in the quaternary care center

Applicability of a modified angular correction measurement method for open-wedge high tibial osteotomy

Tibial slope and patellar height changes following high tibial osteotomy (a comparative study)

Contact Info

Product

Resources

About