Stabilization of high tibial osteotomy with staples

Abstract

Patients presenting with painful arthritis of the medial knee compartment with an intact lateral compartment are treated by high tibial valgus osteotomy at our institution. Between 1989 and 1993, 75 high tibial valgus osteotomies were done. Of these, 52 were idiopathic, 22 post-traumatic, and 1 subsequent to an intra-articular infection of the knee. The condition of the lateral compartment was routinely checked arthroscopically. All osteotomies were stabilized with osteotomy staples. This provided immediate stability, allowing partial weight-bearing (15 kg). Because of the simplicity and the low complication rate, we recommend this technique as a suitable treatment for arthritis of the medial condyle of the knee.

Changes in osseous correction after proximal tibial osteotomy: Radiostereometry of closed- and open-wedge osteotomy in 33 patients

“…Another problem is to maintain the correction achieved during the bone-healing period, and several techniques using different fixations have been described (Ivarsson and Larsson 1989, Koshino et al 1989, Miniaci et al 1989, Yasuda et al 1992, Zuegel et al 1996. In some cases, a gradual loss of correction occurs during the first few years, and could be explained by several factors, i.e., a progression of the gonarthrosis, insufficient bone healing, unbalanced moment forces acting on the knee (Prodromos et al 1985, Wang et al 1990.…”

“…A slight over-correction gives the best shortand long-term results (Kettelkamp et al 1976, Valenti et al 1990, Coventry et al 1993. Various techniques for fixation of the osteotomy had been described, including plaster fixation, orthoses, combinations of staples, plates and external fixation (Ivarsson and Larsson 1989, Koshino et al 1989, Miniaci et al 1989, Yasuda et al 1992, Zuegel et al 1996.…”

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

“…In their reported series in 1996, Zenger et al [17] used an anterolateral incision to perform a closed wedge technique above TT with an oblique fibular osteotomy. They also reported drilling to weaken the medial cortex and fixed the osteotomy with two staples but, if the medial cortex was broken, a lag screw was used.…”

Valgus osteotomy of the tibia with a Puddu plate combined with anterior cruciate ligament reconstruction

“…Várias são as técnicas cirúrgicas de osteotomia tibial proximal descritas para a correção da deformidade em varo do joelho (5,8,9,12,18) . Todas têm por objetivo a transferência para o lado lateral, ainda que parcialmente, da sobrecarga existente no compartimento medial, melhorando a distribuição da pressão de carga sobre o joelho.…”

“…Several surgical techniques of tibial osteotomy were described for knee varus deformity correction (5,8,9,12,18) . All of them aim to move laterally, even though partially, the existing overload at medial side, allowing a better load distribution over the knee.…”