Tibial Osteotomy for Osteoarthritis of the Knee

Jackson, J. P.; Waugh, W.

doi:10.1302/0301-620x.43b4.746

Cited by 386 publications

(183 citation statements)

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“…High tibial osteotomy (HTO) has been an established treatment option for young and active patients with unicompartmental osteoarthritis (OA) of the knee since the 1960s [1][2][3][4]. The mechanical leg axis is one important factor influencing the mechanical load distribution in the knee joint.…”

Section: Introductionmentioning

confidence: 99%

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Ribeiro

Severino

Fucs

2014

International Orthopaedics (SICOT)

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Purpose This study aimed to verify if the navigation system used in high tibial osteotomy (HTO) adds precision to the procedure regarding mechanical axis correction and prevention of tibial slope increases. Methods In this historically controlled study, patients with medial osteoarthrosis and genuvarum underwent HTO between 2004 and 2012; the first 20 were operated with the conventional technique, using pre-planning correction by the Dugdale method and 18 further patients were operated with the navigation system introduced in our hospital. Results The two groups were similar for pre-operative mechanical axis (mean 8.10±3.14 for the control and 6.60± 2.50 for the navigated group), pre-operative tibial slope (mean 8.95±3.47 versus 8.17±3.11, respectively) and Lyshom score (40.85±15.46 and 44.83±16.86). After surgery, the control group presented mean mechanical axis of 3.35±3.27, tibial slope of 13.75±3.75 and Lyshom score of 87.60±11.12. The navigated group showed a postoperative mechanical axis mean of 3.06±1.70, tibial slope of 10.11±0.18 and Lyshom score of 91.94±11.61. Conclusions The navigation system allowed a significantly better control of tibial slope. Patients operated with the navigation system had significantly better Lysholm scores.

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Section: Introductionmentioning

confidence: 99%

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Ribeiro

Severino

Fucs

2014

International Orthopaedics (SICOT)

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“…High tibial osteotomy was first described in 1958 as a successful treatment for moderate to severe unicompartmental, degenerative arthritis of the knee associated with angular deformity [1]. Malalignment is frequently associated with knee arthrosis and can influence the mechanical load through either the medial or lateral compartment.…”

Section: Introductionmentioning

confidence: 99%

High tibial osteotomies in the young active patient

Wolcott

Traub

Efird

2010

International Orthopaedics (SICOT)

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Unicompartmental changes in the knee of a young athlete remains a difficult and controversial problem in orthopaedics. Excessive premature loading of articular cartilage, most often the result of a knee injury, has been shown to result in increased degenerative changes and pain in the younger patient. Instability may also contribute to the degeneration of cartilage and must therefore be considered in the treatment of osteoarthritis in the young adult. High tibial osteotomy has been described as a treatment option for malalignment in the older, less active adult and has shown promising results in a younger, more active population. Osteotomies for instability are more controversial and should be considered in more complex injury patterns.

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“…We are all familiar with radiographs showing the high spot-loading in a subluxing hip, and are also aware that an appropriate osteotomy, which reduces spot-loading by containing the hip, relieved pain. Similarly, in a varus or valgus deformity of knee joint, abnormal distribution of load may lead to unicompartmental osteoarthritis, and an appropriate osteotomy [16,51] especially if done early with minimal cartilage loss, would produce a satisfactory long-term result. We emphasize that the biomechanical effect was to alter the loading pattern, and the resultant clinical effect was pain relief.…”

Section: The Intervertebral Discmentioning

confidence: 99%