High Tibial Osteotomy for Unloading Osteochondral Defects in the Medial Compartment of the Knee

Abstract

This loading situation most closely approximates physiologic loading and therefore represents an ideal outcome for patients with isolated chondral defects. Reduction in stress concentration around chondral defects has been found to favor cartilage repair.

dGEMRIC as a tool for measuring changes in cartilage quality following high tibial osteotomy: a feasibility study

“…The mean mechanical leg axis in this patient group was in accordance with the recommended valgus leg alignment post-HTO 40,41 . The mean change in femorotibial angle was 10 which seems to be large enough to expect significant changes in cartilage loading patterns represented in the dGEMRIC measurements.…”

Can young and active patients participate in sports after osteochondral autologous transfer combined with valgus high tibial osteotomy?

“…This treatment algorithm is consistent with biomechanical data, which show an equal load distribution between the medial and lateral compartment on cadaveric knees between 0° and 4° of valgus [24]. There are no data available about the amount of varus deviation that can be tolerated in case of osteochondral resurfacing.…”

High Tibial Osteotomy in Cartilage Repair

“…Recent biomechanical work has shown that the medial compartment is completely unloaded with correction to between 6° and 10° of anatomic valgus and that the load is equalized between the medial and lateral compartments, with correction to between 0° and 4° of anatomic valgus. The study's authors recommended from these biomechanical data that treatment for varus gonarthrosis be overcorrection of the mechanical axis and that treatment for isolated medial femoral condyle chondral injuries involves only correction to physiologic alignment as opposed to overcorrection [ 13 ]. The fi rst step is to draw the mechanical axis line from the center of the femoral head to the center of the talus.…”