Patient Evaluation and Indications for Osteotomy Around the Knee

Technique for Medial Closing-Wedge Proximal Tibia Osteotomy in the Valgus Knee

“…4,15 Other complications inherent to osteotomy procedures include non-union, malunion, wound complications, infection, thromboembolism, stiffness, and painful hardware requiring reoperation. 1,6,7 There are very few published studies on long-term clinical outcomes after MCWPTO. In the largest series of 47 patients, Chambat et al 4 reported that 72% had "good" or "very good" results with an improvement in pain in 91% at a mean 7 years of follow-up.…”

“…Neutral mechanical alignment is an important factor in the success of these operations, and there has been increased interest in osteotomies to achieve this goal. [1][2][3] Several techniques have been described for correction of valgus malalignment, including distal femoral osteotomy (lateral opening wedge or medial closing wedge) and proximal tibial osteotomy (lateral opening wedge or medial closing wedge). Although distal femoral osteotomies have long been considered the standard for treatment of valgus with lateral compartment disease, these techniques preferentially affect joint contact forces in full extension with less effect at greater knee flexion angles and no effect at 90 or beyond.…”

“…Osteotomies about the knee have long been an established treatment for various pathologies in patients with coronal plane malalignment. 1 More recently, advances in cartilage restoration and meniscal transplant procedures have led to increasing interest in biologic joint reconstruction. Neutral mechanical alignment is an important factor in the success of these operations, and there has been increased interest in osteotomies to achieve this goal.…”

“…Neutral mechanical alignment is an important factor in the success of these operations, and there has been increased interest in osteotomies to achieve this goal. 1 , 2 , 3 …”

Arthroseprävention und mögliche zukünftige Ansätze der Arthrosetherapie – Sicht der Orthopädie und Unfallchirurgie

“…Somit kann die Mehrbelastung des in der Regel geschädigten medialen Kompartiments reduziert und die Progredienz der Arthrose gehemmt werden [13]. Wichtig ist die richtige Indikationsstellung bei intaktem lateralen Kompartiment, stabilem Bandapparat, gutem Bewegungsausmaß, BMI < 30 und Alter möglichst < 50 [12]. Bei korrekter Indikationsstellung können Überlebensraten (Endpunkt Knieprothesenimplantation) von 73 % nach 5 und 52 % nach 10 Jahren erreicht werden [13].…”