Osteotomies around the knee

Brinkman, Justus-Martijn; Lobenhoffer, P.; Agneskirchner, Jens D.; Staubli, Alex E; Wymenga, A. B.; Heerwaarden, Ronald J van

doi:10.1302/0301-620x.90b12.21198

Cited by 341 publications

(184 citation statements)

References 67 publications

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“…Similar results have been demonstrated with both opening-wedge and closing-wedge varus-producing distal femoral osteotomy (DFO) for valgus alignment and isolated lateral compartment knee OA, with a mean survival rate of 80% at 10-year follow-up 13. Indications for realignment osteotomy of the knee have broadened over the past 10–15 years to include patients with knee instability and as adjuvant procedures to unload compartments during meniscus and cartilage restoration 14. In these latter cases, the osteotomy functions by providing an optimal biomechanical environment to address ligament instability, while also offloading the articular surface in the affected compartments to potentially prevent or delay the progression of OA 15…”

Section: Introductionmentioning

confidence: 62%

Realignment osteotomy of the knee allows for return to work and sport activities in the young athletic population

et al. 2018

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Section: Introductionmentioning

confidence: 62%

Realignment osteotomy of the knee allows for return to work and sport activities in the young athletic population

et al. 2018

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“…Among all included studies in this present study, five trials applied OWHTO, seven trials used CWHTO, and one study used hemicallotasis. OWHTO is considered safe and easy [21, 48, 49] based on the assumption that CWHTO may be associated with a higher incidence of complications, especially peroneal nerve paralysis. Despite improved surgical techniques and implant design, previous studies have reported complications after UKA, such as loosening of the tibial or femoral component or osteoarthritic changes in the development of the lateral compartment due to antero–posterior instability of the knee, which leads to rapid wearing of the polyethylene insert [11, 21].…”

Section: Discussionmentioning

confidence: 99%

Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review

Santoso¹,

Wu²

2017

J Orthop Surg Res

109

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Background: Debate remains whether high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA) is more beneficial for the treatment of unicompartmental knee osteoarthritis. The purpose of this study was to compare the functional results, knee scores, activity levels, and complications between the two procedures. Methods: We performed a systematic review of published literature from August 1982 through January 2017. Fifteen papers reporting three prospective randomized trials were subjected to a meta-analysis. Results: No significant difference between the two groups was noted with respect to free walking (velocity), knee score, deterioration of the contralateral or patellofemoral knee, or revision rate and total knee arthroplasty. However, UKA produced better outcomes compared to HTO in terms of the functional results, pain assessment, and complications, although patients who underwent HTO tended to have slightly better range of motion. Conclusions: Valgus HTO provides better physical activity for younger patients whereas UKA is more suitable for older patients due to shorter rehabilitation time and faster functional recovery. Although UKA patients tended to have improved overall long-term outcomes, which may be due to accurate indications and patient selection, both treatment options yielded pleasing results. Therefore, we are unable to conclude that either method is superior.

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“…Medial osteoarthritis of the knee can be treated with open-wedge,valgus, high tibial osteotomy (OW-HTO) (Brinkman et al 2008). There are concerns, however, regarding the ability of the fixation technique to withstand the forces that act on the proximal tibia (Brinkman et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Early full weight bearing is safe in open-wedge high tibial osteotomy

Brinkman¹,

Luites²,

Wymenga³

et al. 2010

Acta Orthopaedica

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Background and purpose In open-wedge, valgus osteotomy of the upper tibia, there are concerns regarding the initial stability and ability to retain the correction. Rehabilitation protocols vary depending on the osteotomy technique and the fixation method. Angle-stable implants offer superior initial stability. Early full weight bearing appears to be possible using these implants. In this prospective cohort study, we measured migration in open-wedge osteotomy in patients following an early full weight bearing protocol and compared the results to those from a historical cohort of open-wedge osteotomy patients who followed a standard protocol (full weight bearing after 6 weeks) using radiostereometry.Methods 14 open-wedge osteotomies fixated with the angle-stable Tomofix implant were performed; patients were allowed full weight bearing as soon as pain and wound healing permitted. Radiostereometry was used to measure motion across the osteotomy at regular intervals. Improvement in pain and functional outcome were assessed postoperatively. The results were compared to those from a group of 23 patients who had undergone the same operation but had used a standard rehabilitation protocol.Results There were no adverse effects because of the early full weight bearing protocol. There were no differences in motion at the osteotomy between groups as measured by radiostereometry. In both groups, pain and function improved substantially without any differences between groups. Patients in the early weight bearing group achieved the same result but in a shorter time.Interpretation Tomofix-plate-fixated open-wedge high tibial osteotomy allows early full weight bearing without loss of correction.

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Osteotomies around the knee

Cited by 341 publications

References 67 publications

Realignment osteotomy of the knee allows for return to work and sport activities in the young athletic population

Realignment osteotomy of the knee allows for return to work and sport activities in the young athletic population

Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review

Early full weight bearing is safe in open-wedge high tibial osteotomy

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