Kniegelenknahe Korrekturosteotomien

Abstract

ZusammenfassungKniegelenknahe Korrekturosteotomien bei unikompartimenteller Gonarthrose haben in den letzten Jahren eine starke Renaissance erlebt. Sie müssen als Alternative zum monokompartimentellen oder kompletten Gelenkersatz mit bedacht werden.

Long-term Outcomes after Medial Open Wedge High Tibial Osteotomy – A Retrospective Study of 69 Patients

“…Der HSS-Score (präoperativ: 69,5 ; Follow-up: 71 [56-86]; p = 0,6941) zeigte keine signifikante Veränderung über den 10-Jahres-Beobachtungszeitraum. Der Lequesne-Score war signifikant niedriger als präoperativ (präoperativ: 11,5 [0, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]; Follow-up: 7 [1][2][3][4][5][6][7][8][9][10][11][12][13]; p < 0,001), was einer geringeren Einschränkung entspricht. Schlussfolgerungen Für die Mehrheit der Patienten mit medialer Gonathrose, die eine Behandlung mittels HTO und Stabilisierung durch eine Tomofix-Platte erhalten, kann erwartet werden, dass mindestens 10 Jahre keine Implantation einer KTP notwendig wird.…”

“…Medial open wedge high tibial osteotomy (HTO) is a widespread and commonly accepted surgery to avoid or delay unicompartmental or total knee arthroplasty (TKA) in patients with medial compartment knee osteoarthritis (OA) and varus malalignment [1,2]. Several mid-to long-term clinical studies have reported good to excellent clinical results demonstrating improvements in quality of life and a high rate of return to sports [3,4,5,6,7].…”

“…Five-and ten-year survival rates were 84.1 and 60.9 %, respectively. Patients without conversion to TKA showed a Lysholm score of 64.5 , Lequesne score of 7 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13), HSS score of 71 (56-86), and Oxford knee score of 38.5 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) at the last follow-up (more than 10 years). Significantly higher scores were registered at the last follow-up compared to the preoperative state regarding the Lysholm score (preoperative: 43.5 ; follow-up: 64.5 ; p < 0.001).…”

“…The Lequesne score was significantly lower than the preoperative score (preoperative: 11.5 [0. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]; follow-up: 7 [1][2][3][4][5][6][7][8][9][10][11][12][13]; p < 0.001), indicating a lower handicap. Conclusions The majority of patients with a valgus medial compartmental knee OA treated with HTO with fixation using the TomoFix plate can expect no conversion to TKA for more than 10 years.…”

Osteotomies and Total Knee Arthroplasty: Systematic Review and Meta-Analysis

“…The mechanical and anatomical principles of osteotomy are of great concern in order to achieve appropriate alignment and joint congruency after surgery [ 8 , 9 ]. The most frequently performed osteotomy is the medial open-wedge high tibial osteotomy (HTO), which is for the treatment of early stage osteoarthritis [ 10 ], and the tibial tubercle osteotomy (TTO), which is for recurrent patella dislocation or patellofemoral arthritis [ 11 ]. Additionally, osteotomies are of common use during total knee arthroplasty (TKA): TTO as an approach for revision surgery or epicondylar osteotomy for TKA balancing [ 12 ].…”