High tibial osteotomy for medial compartment osteoarthritis

Dowd, G.S.E.; Somayaji, H.S.; Uthukuri, M.

doi:10.1016/j.knee.2005.08.002

Cited by 90 publications

(72 citation statements)

References 38 publications

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“…Although it is currently believed that tibial osteotomy is unlikely to give a satisfactory results in patients who have severe preoperative varus deformity [1,4,16,17], in our series this was not found to be true. Most of the knees had a good result at the ten year follow-up examination.…”

Section: Discussioncontrasting

confidence: 68%

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Opening wedge tibial osteotomy for large varus deformity with CeraverTM resorbable beta tricalcium phosphate wedges

Hernigou

Roussignol

Flouzat-Lachaniette

et al. 2009

International Orthopaedics (SICOT)

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The results in 53 knees that had been treated by proximal tibial opening-wedge osteotomy for large varus deformity and osteoarthritis of the medial compartment were evaluated after a mean length of follow-up of ten years (range, 8-12 years). We used a porous betatricalcium phosphate (β-TCP) wedge because it is resorbable and osteoinductive. All osteotomies were completely consolidated and complete osseointegration of the remnant of the β-TCP wedge took place. However, after a mean maximum follow-up of ten years none of the cases showed complete resorption. After ten years, 40 (81%) of the 53 knees had an excellent or good result, and in 13 knees there was recurrent pain for which six had an arthroplasty. Although the results deteriorated with time, time was not the only determinant of the result. Alignment, measured as the hip-knee-ankle angle on radiographs of the whole limb that were made with the patient bearing weight, was also a determinant of long-term results. The best results were obtained in the knees that had a hip-knee-ankle angle of 183-186 degrees. In these knees, there was no pain and no progression of the arthrosis in either the medial or the lateral tibiofemoral compartment. Of the three knees that had an angle of more than 186 degrees, all five had progressive degenerative changes in the lateral compartment. In the undercorrected knees (an angle of less than 183 degrees), the results were less satisfactory, and there was a tendency toward recurrence of the varus deformity and progression of the arthritis of the medial compartment. However, when the correction was insufficient the deterioration was slow. Therefore, proximal tibial osteotomy is a very suitable operation even for patients who have gonarthrosis of the medial compartment and a large varus deformity. Although, a rigidly standardised and precise operative technique is required as well as accurate radiographic measurements of the mechanical axis of the limb because exact postoperative alignment is the prerequisite for the longest possible period of relief of symptoms after osteotomy, and this exact alignment is difficult to obtain for patients with large varus deformity.

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Section: Discussioncontrasting

confidence: 68%

“…It has been well documented that the early results after proximal tibial osteotomy for gonarthrosis are favourable [1][2][3][4]. Osteoarthritis of the knee is often associated with varus malalignment of the affected extremity.…”

Section: Introductionmentioning

confidence: 99%

Opening wedge tibial osteotomy for large varus deformity with CeraverTM resorbable beta tricalcium phosphate wedges

Hernigou

Roussignol

Flouzat-Lachaniette

et al. 2009

International Orthopaedics (SICOT)

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“…Other reasons for failure include inaccurate correction during surgery. Furthermore, undercorrection [8] leads to progression of medial joint arthritis [9] and patient dissatisfaction [10]. On the other side, overcorrection leads to patellar subluxation, patella baja [9], medial joint opening [7] and rapid degeneration of the lateral cartilage [11].…”

Section: Introductionmentioning

confidence: 99%

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Ribeiro

Severino

Fucs

2014

International Orthopaedics (SICOT)

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Purpose This study aimed to verify if the navigation system used in high tibial osteotomy (HTO) adds precision to the procedure regarding mechanical axis correction and prevention of tibial slope increases. Methods In this historically controlled study, patients with medial osteoarthrosis and genuvarum underwent HTO between 2004 and 2012; the first 20 were operated with the conventional technique, using pre-planning correction by the Dugdale method and 18 further patients were operated with the navigation system introduced in our hospital. Results The two groups were similar for pre-operative mechanical axis (mean 8.10±3.14 for the control and 6.60± 2.50 for the navigated group), pre-operative tibial slope (mean 8.95±3.47 versus 8.17±3.11, respectively) and Lyshom score (40.85±15.46 and 44.83±16.86). After surgery, the control group presented mean mechanical axis of 3.35±3.27, tibial slope of 13.75±3.75 and Lyshom score of 87.60±11.12. The navigated group showed a postoperative mechanical axis mean of 3.06±1.70, tibial slope of 10.11±0.18 and Lyshom score of 91.94±11.61. Conclusions The navigation system allowed a significantly better control of tibial slope. Patients operated with the navigation system had significantly better Lysholm scores.

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“…Opening-wedge high tibial osteotomy (OWHTO) is a surgical procedure used to treat relatively early-stage medial compartment knee OA. 1,2) By changing the axis of the lower limb using an extra-articular approach, OWHTO preserves the native articular surface and decreases the excess stress in the medial compartment of the knee. [3][4][5] After OWHTO, patients generally have no limits on their activities of daily living.…”

Section: Introductionmentioning

confidence: 99%

“…Excellent clinical results of OWHTO have been reported. [1][2][3][4][5] However, the activities performed by patients with knee OA before and after osteotomy have rarely been described. The sports and physical activities (SPA) performed by patients with knee OA before and after valgus knee osteotomy have been investigated and several reports have been published.…”

Section: Introductionmentioning

confidence: 99%

Sports and Physical Activities of Elderly Patients with Medial Compartment Knee Osteoarthritis after High Tibial Osteotomy

Kamada

Shiota

Sakamoto

et al. 2017

PRM

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High tibial osteotomy for medial compartment osteoarthritis

Cited by 90 publications

References 38 publications

Opening wedge tibial osteotomy for large varus deformity with CeraverTM resorbable beta tricalcium phosphate wedges

Opening wedge tibial osteotomy for large varus deformity with CeraverTM resorbable beta tricalcium phosphate wedges

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Sports and Physical Activities of Elderly Patients with Medial Compartment Knee Osteoarthritis after High Tibial Osteotomy

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