High Tibial Osteotomy

Wright, John; Crockett, Heber C.; Slawski, Daniel P.; Madsen, Mike W.; Windsor, Russell E.

doi:10.5435/00124635-200507000-00007

Cited by 139 publications

(110 citation statements)

References 61 publications

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Section: Introductionmentioning

confidence: 99%

“…Both lateral closing wedge and medial opening wedge techniques have been described for these indications and have been shown to produce satisfactory clinical results [3,4,10,22]. Complications such as fracture, inadequate correction, patella infera, compartment syndrome, arthrofibrosis, infection and delayed union or non-union may complicate both of these methods [13,22]. However, because of the problems in the lateral closing wedge osteotomy related to detachment of the extensor muscles, fibular osteotomy, peroneal nerve injuries, disruption of the proximal tibio-fibular joint and shortening of the limb, medial opening wedge high tibial osteotomy (MOWHTO) has become increasingly popular in recent years [1,6,13,19].…”

Section: Introductionmentioning

confidence: 99%

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Bone allograft provides bone healing in the medial opening high tibial osteotomy

Šantić¹,

Tudor²,

Šestan³

et al. 2009

International Orthopaedics (SICOT)

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Various materials are used to fill osteotomy defects created in the medial opening wedge high tibial osteotomy (MOWHTO). Our hypothesis was that a bone allograft would provide the osteotomy site bone healing within the expected time. We performed the MOWHTO using a cancellous bone allograft in 310 knees in 284 patients between 2000 and 2005.Internal fixation was achieved with a T-profile AO plate. Preoperative and postoperative radiographic measurements were taken and statistically processed. All patients were followed up for a period ranging from three to eight years, or 5.9 years on average. Implanted cancellous bone allografts ≤9 mm healed within 12 weeks in 90% of cases. With the properly selected patient and surgical technique, use of a cancellous bone allograft in MOWHTO represents a satisfactory choice in providing bone healing.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bone allograft provides bone healing in the medial opening high tibial osteotomy

Šantić¹,

Tudor²,

Šestan³

et al. 2009

International Orthopaedics (SICOT)

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“…Furthermore, at the same time, the number of unicondylar knee arthroplasties (UKA) has grown [2], which may also have contributed to the decreased number of osteotomies performed. However, symptomatic and radiographically mild to moderate knee OA in young and active patients is still commonly regarded as an indication for high tibial osteotomy [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Incidence of osteotomies around the knee for the treatment of knee osteoarthritis: A 22-year population-based study

Niinimäki

Eskelinen

Ohtonen

et al. 2012

International Orthopaedics (SICOT)

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Purpose Both tibial and femoral osteotomies have been used for the treatment of knee osteoarthritis (OA). Due to the clinical success of total knee arthroplasty (TKA) the current role and incidence of osteotomies remains unknown. The aim of this population-based study was to assess the incidence of osteotomies and compare it with that of knee arthroplasties. Methods From the Finnish National Hospital Discharge Register, we identified all patients, aged 18 years or more, who had undergone osteotomy for the treatment of knee OA between 1987 and 2008. The number of arthroplasties was extracted from the Arthroplasty Register. Results A total of 6,004 osteotomies were performed for 5,734 patients. The average osteotomy incidence has steadily decreased by 6.2%, and TKA incidence has increased by 9.8% annually. However, in patients aged less than 50 years the osteotomy incidence has increased by 1.4% annually. The decline of osteotomy incidence has been steeper in females than in males (9.0% vs. 3.6%), and during the last decade osteotomies were more commonly performed in male patients. ConclusionIncidence of osteotomies for the treatment of knee OA has decreased during last two decades. However, in patients aged less than 50 years the osteotomy incidence has slightly increased. In a comparison by gender, females are more likely to undergo arthoplasty than osteotomy, and it would therefore appear that the current use of osteotomies is predominantly reserved for the treatment of knee OA in relatively young males.

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“…In such cases, a valgus-producing medial opening wedge proximal tibial osteotomy (PTO) has been proposed to restore neutral mechanical alignment and alleviate excess load on the medial compartment. 1,[3][4][5] This technique has been reported to produce significant improvement in subjective and objective clinical outcome scores when treating medial compartment overload. 6,7 Recently, the indications for this technique have expanded to include the treatment of chronic central and posterolateral ligamentous instability, and also to protect ligament reconstructions in the setting of varus malalignment.…”

mentioning

confidence: 99%

Medial Opening Wedge Proximal Tibial Osteotomy

Chahla

Dean

Mitchell

et al. 2016

Arthroscopy Techniques

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Genu varus malalignment can lead to medial compartment overload and progression of ipsilateral compartment osteoarthritis. To slow this process, a medial opening wedge proximal tibial osteotomy (PTO) can be performed. This type of PTO is indicated in patients with genu varus malalignment and isolated medial compartment osteoarthritis of the knee, prior to or concurrent with medial compartment cartilage procedures or meniscal transplants, chronic posterolateral corner deficiency, or chronic anterior cruciate ligament deficiency. When treating ligamentous instability, a PTO can be performed in isolation, with simultaneous ligament reconstruction, or as a staged procedure with the osteotomy first, followed by ligament reconstruction if instability persists. Failure to address malalignment in cases of concurrent ligament reconstruction leads to increased stress on the graft and potential graft failure. One distinct advantage of this procedure is the ability to correct deformities in the sagittal and coronal planes. The purpose of this article was to describe our technique used to perform a medial opening wedge PTO.

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High Tibial Osteotomy

Cited by 139 publications

References 61 publications

Bone allograft provides bone healing in the medial opening high tibial osteotomy

Bone allograft provides bone healing in the medial opening high tibial osteotomy

Incidence of osteotomies around the knee for the treatment of knee osteoarthritis: A 22-year population-based study

Medial Opening Wedge Proximal Tibial Osteotomy

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