Osteotomies for the Management of Medial Compartment Defects of the Knee

Abstract

For nearly three-quarters of a century the proximal tibia osteotomy has been used as an effective treatment for cartilage injuries of the knee. Over this same timeframe several advancements have been made in our diagnostic, preoperative planning, and technical execution of this procedure. As such, good-to-excellent short-, mid-, and long-term outcomes have been reported. Since its inception, the most important step in deciding on this procedure is identifying the ideal candidate. This candidate should be a young patient (<55 years old), active, with isolated medial compartment arthrosis without significant comorbidities. With appropriate patient selection and careful preoperative planning, the patient should achieve excellent results and high satisfaction.

Engaging Patients and Caregivers to Develop a Patient-Centered Agenda for Comparative Effectiveness Research Focused on the Treatment of Complex Knee Problems

“…[5][6][7][8][9][10][11][12][13][14] As such, these patients may pursue other surgical treatment options that include osteotomies, joint distraction, or osteochondral allograft (OCA) transplantation when available and indicated. 9,[15][16][17][18][19][20][21][22] Currently, there is evidence to support artificial knee arthroplasty (TKA or UKA) in older (>60 years), sedentary patients and for biological resurfacing using OCA transplantation in younger (<45 years), active patients. 3,15,[23][24][25] However, "middle-aged" patients between 45 and 60 years of age who wish to remain highly active (and their health care professionals) do not have robust guiding evidence such that the default decision is often to delay surgical treatment for as long as possible, take medications, profoundly alter their lifestyle, and wait for years until TKA is definitively indicated.…”