Results of HTO in medial OA of the knee

Amendola, Annunziato; Bonasia, Davide Edoardo

doi:10.1007/978-2-287-99353-4_56

Cited by 5 publications

(4 citation statements)

References 61 publications

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“…12 Regarding the material used to fill the gap created by the osteotomy, several compounds have been used such as autograft, allograft, synthetic bone substitutes (hydroxyapatite, b-tricalcium phosphate, a combination of both and bone cement) with or without platelet-rich plasma, growth factors, and bone marrow aspirate concentrate. 20,21 To date, bone graft is considered the gold standard bone filling material because of its osteoconductive, osteoinductive, and osteogenic properties. 21 Bone substitute avoids donor site morbidity associated with bone autograft; however, bone substitute provides weaker resistance to compressive loading forces.…”

Section: Discussionmentioning

confidence: 99%

“…20,21 To date, bone graft is considered the gold standard bone filling material because of its osteoconductive, osteoinductive, and osteogenic properties. 21 Bone substitute avoids donor site morbidity associated with bone autograft; however, bone substitute provides weaker resistance to compressive loading forces. 20,22 It has been reported that gaps of less than 10 mm can be left unfilled because no pseudarthrosis or loss of correction was observed in a series of 112 patients.…”

Section: Discussionmentioning

confidence: 99%

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Medial Opening Wedge Proximal Tibial Osteotomy

Chahla

Dean

Mitchell

et al. 2016

Arthroscopy Techniques

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Genu varus malalignment can lead to medial compartment overload and progression of ipsilateral compartment osteoarthritis. To slow this process, a medial opening wedge proximal tibial osteotomy (PTO) can be performed. This type of PTO is indicated in patients with genu varus malalignment and isolated medial compartment osteoarthritis of the knee, prior to or concurrent with medial compartment cartilage procedures or meniscal transplants, chronic posterolateral corner deficiency, or chronic anterior cruciate ligament deficiency. When treating ligamentous instability, a PTO can be performed in isolation, with simultaneous ligament reconstruction, or as a staged procedure with the osteotomy first, followed by ligament reconstruction if instability persists. Failure to address malalignment in cases of concurrent ligament reconstruction leads to increased stress on the graft and potential graft failure. One distinct advantage of this procedure is the ability to correct deformities in the sagittal and coronal planes. The purpose of this article was to describe our technique used to perform a medial opening wedge PTO.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medial Opening Wedge Proximal Tibial Osteotomy

Chahla

Dean

Mitchell

et al. 2016

Arthroscopy Techniques

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“…Many techniques have been developed (i.e. closing wedge, opening wedge, dome and chevron osteotomies), but opening (medial) and closing (lateral) wedge osteotomies are the most commonly used [6,7] . In 1965, Coventry described the closed wedge technique (CWO) for HTO.…”

Section: Introductionmentioning

confidence: 99%

“…Although overall HTO results show the effectiveness of the procedure [9] , there are still some debated issues about osteotomies. The issues include the choice between opening or closing wedge tibial osteotomy, the graft selection in opening wedge osteotomies, the type of fixation, the comparison with unicompartmental knee arthroplasty (UKA) and whether HTO affects a subsequent total joint replacement (TKR) [6] .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of functional outcome of high tibial osteotomy in medial compartment osteoarthritis of knee fixed with orthofix and puddu plate: A comparative study

Khan¹,

Ifthekar²

2018

Int. J. Orthop. Sci.

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Introduction: Osteoarthritis of knee joint is the most common form of arthritis, affecting a huge population of about 237 million (3.3% of the population). Among those over 60 years old, about 10% of males and 18% of females are affected. Medial compartment is a common disease, caused by additional force on the medial compartment as a result of varus malalignment. The high tibial osteotomy (HTO) is one possibility for the treatment of varus gonarthrosis. Especially for younger and active patients this method can produce long-term relief, which often significantly delays the need for knee arthroplasty. Various techniques for valgus HTOs are described. High tibial osteotomy (HTO) is a widely performed procedure to treat medial knee arthrosis. Materials and Methods: This was a prospective study of 30 patients in the age group between 50 years and 70 years of medial compartment osteoarthritis of knee joint treated by opening wedge osteotomy fixed with orthofix and puddu plate. The study was conducted in the Department of Orthopaedics, SRMS IMS, Bareilly in between September 2016 to march 2018.Patients were randomly allocated in two groups by a computer generated selection system. Their functional results were analysed using knee soceity score. Results: Statistical analysis was performed to compare the demographic characteristics between two groups. The groups were compared with regards to age and sex, grade of osteoarthritis, time of consolidation and functional outcome. Majority of patients were males accounting to 73.33% n=22). Mean age of patients was 61.5years. Minimum age in this series was 52 years and maximum age in this series was 70 years. An unilateral Osteotomy was done in a single setting even when bilateral procedures were required. In our study bilateral osteotomy was done in 12 (40%) patients out of 30 patients. 18 Patients were treated unilaterally (60%).Among unilaterally treated patients majority of these were treated on right knee. Conclusion: Shorter follow-up period is the main shortcoming of our study. However, early results obtained indicate that medial open-wedge osteotomies in medial compartment osteoarthritis of knee fixed using Puddu plates and ortho fix could be done safely and effectively with considerable success with encouraging outcomes, and this technique could be a good alternative for unicompartmental total knee arthroplasty.

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Results of high tibial osteotomy: review of the literature

Amendola

Bonasia

2009

International Orthopaedics (SICOT)

331

305

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The aim of this review is to evaluate long-term follow-up and survival analysis studies regarding high tibial osteotomies (HTO) for the treatment of medial knee arthritis. Despite the good number of studies available, comparison and pooling of the results are challenging because of the different evaluation systems and techniques used. However, in general, published studies on HTO report good long-term results with a correct patient selection and a precise surgical technique. Based on our findings, the ideal candidate for an HTO is a young patient (<60 years of age), with isolated medial osteoarthritis, with good range of motion and without ligamentous instability. Furthermore, the literature review shows that the outcomes gradually deteriorate with time.

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Results of HTO in medial OA of the knee

Cited by 5 publications

References 61 publications

Medial Opening Wedge Proximal Tibial Osteotomy

Medial Opening Wedge Proximal Tibial Osteotomy

Evaluation of functional outcome of high tibial osteotomy in medial compartment osteoarthritis of knee fixed with orthofix and puddu plate: A comparative study

Results of high tibial osteotomy: review of the literature

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