High Tibial Osteotomy

Distal femoral varus osteotomy combined with tibial plateau fresh osteochondral allograft for post-traumatic osteoarthritis of the knee

“…Realignment osteotomies around the knee are a well‐established treatment for symptomatic primary knee osteoarthritis (OA) in younger patients and have been shown to relieve pain and redistribute the weight‐bearing axis by off‐loading the affected compartment [5, 7, 12, 13, 19, 22]. While the results of proximal tibial valgus osteotomy in appropriately selected patients with varus deformity and medial compartment arthritis are encouraging [9, 12], the results of a proximal tibial varus osteotomy for primary valgus deformity of the knee are less favourable, especially if the valgus deformity is greater than 12° or if the correction will result in a tibio‐femoral tilt of more than 10° [16, 18]. In this setting, a distal femoral varus osteotomy is preferred, with the reported 10‐year survivorship ranging from 83 to 87 % [2, 4, 21].…”

Age predicts outcome of high-tibial osteotomy

“…at surgery 56.2±6.1 years; range 42-64 years; 52 patients). Mean follow-up time was 11.9±2.2 years (range [10][11][12][13][14][15][16] in the older group and 13±2.5 years (range 8-17) in the younger patients. Mean follow up of all patients was 12.7±2.4 years (range 9-17) with a mean age at surgery of 59.8±7.8 years.…”

A systematic review of outcomes of high tibial osteotomy for the valgus knee

“…Surin [26] 1975 Retrospective case series IV Fair Tjornstrand [41] 1981 Retrospective case series IV Fair van Lieshout [17] 2020 Retrospective case series III Fair W-Dahl [24] 2017 Retrospective case series IV Good A number of additional papers were found to report the outcomes of HTO for medial OA and lateral OA; However, as the patient groups were combined, these particular papers were not eligible for inclusion in this review. Of the 17 papers that were included, there were 13 case series (76.5 %), one cohort study (5.9 %), one case control study (5.9 %) and two literature reviews that reported data which was not published elsewhere (11.6 %) (Table 1).…”

“…Mirouse [18] 52 % considered as failures at a mean 4.3 years 5 year survival = 57.5 % 70 % required TKR by final follow-up at 5 ± 2.7 years Puddu [27] Shoji [16] 26 % developed subluxation; 4 % retained medial thrust Surin [26] Tjornstrand [41] 33 % required further surgery within 7 years van Lieshout [17] 25 % were unstable at a mean of 4.5 years 5-year survival = 79.9 % 19 % required arthroscopy; 3 % required second HTO due to overcorrection; 12 % required TKR W-Dahl [24] 33 % required TKR within 10 years TKR -Total knee replacement.…”