Periarticular Osteotomies for Degenerative Joint Disease of the Knee

Gardiner, Aaron; Richmond, John C.

doi:10.1097/jsa.0b013e31826d2f5d

Cited by 14 publications

(9 citation statements)

References 43 publications

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“…Complications of DFO are similar to HTO and include delayed union or nonunion, fracture, rotational deformity, infection, vascular injury, and deep venous thrombosis. 87 , 88 DFO has been established for treatment of isolated lateral compartment arthritis in select patients, with a mean survivorship of 80% at 10-year follow-up 30 , 33 , 120 In addition, the Ilizarov method can be used in which a distracting external fixator is applied after osteotomy formation, with adjustments made to distract callus formation. 37 …”

Section: Treatmentmentioning

confidence: 99%

The Meniscus-Deficient Knee

Rao

Erickson

Cvetanovich

et al. 2015

Orthopaedic Journal of Sports Medicine

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Meniscal tears are the most common knee injury, and partial meniscectomies are the most common orthopaedic surgical procedure. The injured meniscus has an impaired ability to distribute load and resist tibial translation. Partial or complete loss of the meniscus promotes early development of chondromalacia and osteoarthritis. The primary goal of treatment for meniscus-deficient knees is to provide symptomatic relief, ideally to delay advanced joint space narrowing, and ultimately, joint replacement. Surgical treatments, including meniscal allograft transplantation (MAT), high tibial osteotomy (HTO), and distal femoral osteotomy (DFO), are options that attempt to decrease the loads on the articular cartilage of the meniscus-deficient compartment by replacing meniscal tissue or altering joint alignment. Clinical and biomechanical studies have reported promising outcomes for MAT, HTO, and DFO in the postmeniscectomized knee. These procedures can be performed alone or in conjunction with ligament reconstruction or chondral procedures (reparative, restorative, or reconstructive) to optimize stability and longevity of the knee. Complications can include fracture, nonunion, patella baja, compartment syndrome, infection, and deep venous thrombosis. MAT, HTO, and DFO are effective options for young patients suffering from pain and functional limitations secondary to meniscal deficiency.

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Section: Treatmentmentioning

confidence: 99%

The Meniscus-Deficient Knee

Rao

Erickson

Cvetanovich

et al. 2015

Orthopaedic Journal of Sports Medicine

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“…2,3 However, HTO may offer some advantages to these patients: (1) it preserves bone stock and (2) it allows for implementing an active postoperative life style without associating the risk for requiring increasingly complex reoperations derived from progressive wear of the implants. 4 HTO's key biomechanical element is based on the modification of the mechanical axis for unloading the medial compartment. 5 Traditionally, closing wedge osteotomy was the most widely used HTO due to its lower technical difficulty and higher primary stability.…”

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confidence: 99%

3D Surgical Printing Cutting Guides for Open-Wedge High Tibial Osteotomy: Do It Yourself

et al. 2016

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Opening wedge osteotomy has recently gained popularity, thanks to the recent implementation of locking plates, which have shown equivalent stability with greater reproducibility, accuracy, and longevity than the closing wedge techniques and a lower prosthetic conversion rate. We present a new "do-it-yourself" cutting guides system for tibial opening osteotomy. Using a conventional computed tomography digital image, a positioning guide and wedge spacers were printed in three dimensions (3D) for implementing the osteotomy and obtaining the planned correction. The surgeon makes the whole process in a do-it-yourself style. This new technique was used in eight cases. Previous opening osteotomies with the standard technique were used as control (20 cases). Surgical time, fluoroscopic time, and accuracy of the axial correction were measured. The use of a custom positioning guide reduced the surgical (31 minutes less) and fluoroscopic times (6.9 times less) while achieving a high-axis correction accuracy compared with the standard technique. Digitally planned and executed osteotomies under 3D printed osteotomy positioning guides help the surgeon to minimize human error while reducing surgical time. The reproducibility of this technique is very robust, allowing a transfer of the steps planned in a virtual environment to the operating table.

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“…4 8 Medial closing-wedge osteotomies seemed to have more complications, but a great deal of this information came from older studies, in which surgeons used clamping methods rather than additional plates and screws. 9 We believe that the medial closing-wedge technique allows a more anatomical correction with a shorter consolidation time. In addition, it eliminates the need for bone grafting and earlier loading on the operated limb.…”

Section: Discussionmentioning

confidence: 90%

Osteotomias femorais distais com cunha de fechamento medial—estudo retrospectivo

Cabral¹,

Astur

Freitas³

et al. 2019

Rev Bras Ortop

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Resumo Objetivo Descrever a técnica cirúrgica da osteotomia femoral com cunha de fechamento medial e uma série de casos submetidos a essa técnica. Métodos Foram avaliados 26 pacientes submetidos a osteotomia femoral distal com cunha de fechamento medial de 2002 a 2013. Os prontuários e exames de imagem de todos os pacientes foram revisados para avaliação do grau de correção e estado atual. Resultados Dos 26 pacientes operados, 12 eram do sexo masculino e 14 do feminino. A idade média foi de 47,15 anos. Em todos os casos, obteve-se alinhamento neutro em relação ao eixo anatômico. A maioria dos pacientes alcançou a consolidação óssea da osteotomia com seis semanas. Não foram observados casos de sangramentos durante a cirurgia. Um paciente apresentou retardo da consolidação óssea. Um paciente apresentou desconforto sobre a placa, foi necessária sua retirada. Um paciente apresentou infecção superficial sem necessidade de revisão da osteotomia. Não foram observados casos de trombose venosa profunda e tromboembolismo pulmonar. Até o momento não houve conversão para artroplastia total de joelho. Conclusão O tratamento com osteotomia femoral distal com cunha de fechamento medial manteve a correção proposta em pacientes com seguimento de até 15 anos.

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Periarticular Osteotomies for Degenerative Joint Disease of the Knee

Cited by 14 publications

References 43 publications

The Meniscus-Deficient Knee

The Meniscus-Deficient Knee

3D Surgical Printing Cutting Guides for Open-Wedge High Tibial Osteotomy: Do It Yourself

Osteotomias femorais distais com cunha de fechamento medial—estudo retrospectivo

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