Proximal tibial osteotomies for the medial compartment arthrosis of the knee: a historical journey

Esenkaya, Irfan; Unay, Koray; Akan, Kaya

doi:10.1007/s11751-012-0131-x

Cited by 14 publications

(7 citation statements)

References 40 publications

(29 reference statements)

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“…Surgical techniques have since been refined, and several forms have been described depending on the type and degree of knee malalignment. 12 These include lateral closing wedge osteotomy, medial opening wedge high tibial osteotomy (MOWHTO), dome osteotomy, Chevron osteotomy, and use of external fixators with gradual correction of knee malalignment.…”

Section: Brief History Of High Tibial Osteotomymentioning

confidence: 99%

Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?

Thambiah

Tan

Hui

2017

IJOO

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Malalignment of the knee can cause debilitating symptoms such as pain, resulting in a decline in function and mobility. Surgical options that exist to address this problem include realignment osteotomies and joint replacements. Realignment osteotomies are the more appropriate options in certain patient populations, especially with regard to age and level of activity. Since a high tibial osteotomy (HTO) was first used to manage malalignment of the knee and osteoarthritis, different techniques involving the use of specialized implants have been developed and further refined to good effect. There has also since been much research into the field of cartilage restoration techniques, both as a standalone treatment option and as an adjunct to a realignment osteotomy. This review attempts to detail the origin and the evolution of HTO, particularly in regard to combining this tried and tested procedure with adjunct cartilage restoration techniques, and the overall patient outcomes. A literature search on PubMed was performed, and articles pertaining to the outcomes of the use of an HTO and cartilage restoration techniques were reviewed. The literature in this field indicates good outcomes in terms of objective measurements of cartilage regeneration (such as arthroscopic visualization and magnetic resonance imaging evaluation) and subjective patient outcome scoring systems (such as the International Knee Documentation Committee and Lysholm scores) with a realignment osteotomy alone, and studies have shown that patient outcomes can be further improved with the use of a cartilage restoration procedure as an adjunct.

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Section: Brief History Of High Tibial Osteotomymentioning

confidence: 99%

Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?

Thambiah

Tan

Hui

2017

IJOO

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“…[3–7] Among them, opening-wedge high tibial osteotomy (OWHTO) and closing-wedge high tibial osteotomy (CWHTO), which involve stabilization with a locking plate, are 2 of the most frequently used techniques. [8–10] OWHTO is a relatively new technology. Compared with CWHTO, there is less involvement in the surgical technique, such as a single patella incision without the need for humeral osteotomy.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of opening-wedge high tibial osteotomy in treating unicompartmental knee osteoarthritis

et al. 2019

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Background: High tibial osteotomy (HTO) is an effective surgical technique that can stop or inhibit the progression of unicompartmental knee osteoarthritis (KOA) to avoid or postpone the need for knee arthroplasty in patients. Whether opening-wedge high tibial osteotomy (OWHTO) is superior to closing-wedge high tibial osteotomy (CWHTO) in treating unicompartmental KOA remains controversial. Methods: Databases (Cochrane Library, EMBASE, and PubMed) were searched from their establishment to July 1, 2018 for randomized controlled trials comparing the application of OWHTO to CWHTO in patients with unicompartmental KOA. The methodological quality of each included study was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions guideline. Review Manager 5.3.5 software (Cochrane Collaboration, Oxford, UK) was used to synthesize the final results. Results: The results will provide useful information about the effectiveness and safety of OWHTO in patients with unicompartmental KOA. Conclusion: The findings of the study will be published in a peer-reviewed journal. PROSPERO registration number: CRD4201811805.

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“…In previous studies, various techniques of HTO were documented and evaluated. Among them, closing-wedge HTO and opening-wedge HTO, which were stabilized by a locking plate [ 3 , 4 ], were two of the most frequently used techniques. For the closing-wedge HTO, a wedge-shaped cut is made in the lateral; while for the opening-wedge HTO, the medial tibia is cut.…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical and radiological outcomes between opening-wedge and closing-wedge high tibial osteotomy: A comprehensive meta-analysis

Lin²,

Jin

et al. 2017

PLoS ONE

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High tibial osteotomy (HTO) has been widely used for clinical treatment of osteoarthritis of the medial compartment of the knee, and both opening-wedge and closing-wedge HTO are the most commonly used methods. However, it remains unclear which technique has better clinical and radiological outcomes in practice. To systematically evaluate this issue, we conducted a comprehensive meta-analysis by pooling all available data for the opening-wedge HTO and closing-wedge HTO techniques from the electronic databases including PubMed, Embase, Wed of Science and Cochrane Library. A total of 22 studies encompassing 2582 cases were finally enrolled in the meta-analysis. There was no significant difference regarding surgery time, duration of hospitalization, knee pain VAS, Lysholm score and HSS knee score (clinical outcomes) between the opening-wedge and closing-wedge HTO groups (P > 0.05). However, the opening-wedge HTO group showed wider range of motion than the closing-wedge HTO group (P = 0.003). Moreover, as for Hip-Knee-Ankle angle and mean angle of correction, no significant difference was observed between the opening-wedge and closing-wedge HTO groups (P > 0.05), while the opening-wedge HTO group showed greater posterior tibial slope angle (P < 0.001) and lesser patellar height than the closing-wedge HTO group (P < 0.001). On light of the above analysis, we believe that individualized surgical approach should be introduced based on the clinical characteristics of each patient.

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Proximal tibial osteotomies for the medial compartment arthrosis of the knee: a historical journey

Cited by 14 publications

References 40 publications

Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?

Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?

The efficacy and safety of opening-wedge high tibial osteotomy in treating unicompartmental knee osteoarthritis

Comparison of clinical and radiological outcomes between opening-wedge and closing-wedge high tibial osteotomy: A comprehensive meta-analysis

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