Lateral Closing-Wedge High Tibial Osteotomy

2020 ◽  
pp. 141-147
Author(s):  
Philipp von Roth ◽  
Clemens Gwinner
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Closing Wedge ◽  
Wedge High Tibial Osteotomy

scholarly journals Proximal Tibiofibular Dislocation in Closing-Wedge High Tibial Osteotomy Increases the Risk of Medium and Long-Term Total Knee Replacement

2021 ◽  
Vol 10 (13) ◽  
pp. 2743
Author(s):  
Juan Sánchez-Soler ◽  
Alex Coelho ◽  
Raúl Torres-Claramunt ◽  
Berta Gasol ◽  
Albert Fontanellas ◽  
...  
Keyword(s):  
Survival Rate ◽  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Closing Wedge ◽  
Wedge High Tibial Osteotomy ◽  
Total Knee ◽  
Group 2 ◽  
Group 1

Proximal tibiofibular dislocation in closing-wedge high tibial osteotomy increases the risk of medium and long-term total knee replacement. Background: High tibial osteotomy is an effective treatment for medial osteoarthritis in young patients with varus knee. The lateral closing-wedge high tibial osteotomy (CWHTO) may be managed with tibiofibular dislocation (TFJD) or a fibular head osteotomy (FHO). TFJD may lead to lateral knee instability and thereby affect mid- and long-term outcomes. It also brings the osteotomy survival rate down. Objective: To compare the CWHTO survival rate in function of tibiofibular joint management with TFJD or FHO, and to determine whether medium and long-term clinical outcomes are different between the two procedures. Material & Methods: A retrospective cohort study was carried out that included CWHTO performed between January 2005 to December 2018. Those patients were placed in either group 1 (FHO) or Group 2 (TFJD). Full-leg weight-bearing radiographs were studied preoperatively, one year after surgery and at final follow-up to assess the femorotibial angle (FTA). The Rosenberg view was used to assess the Ahlbäck grade. The Knee Society Score (KSS) was used to assess clinical outcomes and a Likert scale for patient satisfaction. The total knee replacement (TKR) was considered the end of the follow-up and the point was to analyze the CWHTO survival rate. A sub-analysis of both cohorts was performed in patients who had not been FTA overcorrected after surgery (postoperative FTA ≤ 180°, continuous loading in varus). Results: A total of 230 knees were analyzed. The follow-up period ranged from 24–180 months. Group 1 (FHO) consisted of 105 knees and group 2 (TFJD) had 125. No preoperative differences were observed in terms of age, gender, the KSS, FTA or the Ahlbäck scale; neither were there any differences relative to postop complications. The final follow-up FTA was 178.7° (SD 4.9) in group 1 and 179.5° (SD 4.2) in group 2 (p = 0.11). The Ahlbäck was 2.21 (SD 0.5) in group 1 and 2.55 (SD 0.5) in group 2 (p = 0.02) at the final follow-up. The final KSS knee values were similar for group 1 (86.5 ± 15.9) and group 2 (84.3 ± 15.8). Although a non-significant trend of decreased HTO survival in the TFJD group was found (p = 0.06) in the sub-analysis of non-overcorrected knees, which consisted of 52 patients from group 1 (FHO) and 58 from group 2 (TFJD), 12.8% of the patients required TKR with a mean of 88.8 months in group 1 compared to 26.8% with a mean of 54.9 months in the case of group 2 (p = 0.005). However, there were no differences in clinical and radiological outcomes. Conclusion: TFJD associated with CWHTO shows an increase in the conversion to TKR at medium and long-term follow-up with lower osteotomy survival than the CWHTO associated with FHO, especially in patients with a postoperative FTA ≤ 180° (non-overcorrected). There were no differences in clinical, radiological or satisfaction results in patients who did not require TKR. Level of evidence III. Retrospective cohort study.

Medial Closing-Wedge High Tibial Osteotomy

2020 ◽  
pp. 187-201
Author(s):  
Jean-Marie Fayard ◽  
Nicolas Jan ◽  
Padhraig O’Loughlin ◽  
Benjamin Freychet
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Closing Wedge ◽  
Wedge High Tibial Osteotomy

Proximal tibiofibular division in lateral closing wedge high tibial osteotomy does not increase varus instability of the knee

The Knee ◽  
2019 ◽  
Vol 26 (6) ◽  
pp. 1299-1305 ◽  
Author(s):  
Jae-Young Park ◽  
Jong-Keun Kim ◽  
Hyuk-Soo Han ◽  
Myung Chul Lee
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Closing Wedge ◽  
Wedge High Tibial Osteotomy ◽  
Varus Instability

scholarly journals An Acute Oblique Osteotomy and Suture Ligation Procedure to Shorten the Fibula in Lateral Closing-Wedge High Tibial Osteotomy

2020 ◽  
Vol 9 (9) ◽  
pp. e1299-e1308
Author(s):  
Kazunori Yasuda ◽  
Eiji Kondo ◽  
Daisuke Ueda ◽  
Jun Onodera ◽  
Koji Yabuuchi ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Suture Ligation ◽  
Oblique Osteotomy ◽  
Closing Wedge ◽  
Wedge High Tibial Osteotomy

Paper # 242: Lateral Closing Wedge High Tibial Osteotomy with Fibular Shaft Osteotomy versus Tibiofibular Division

2011 ◽  
Vol 27 (10) ◽  
pp. e230-e231
Author(s):  
Jak Jang ◽  
Myung Chul Lee ◽  
Sahnghoon Lee ◽  
Joon Kyu Lee ◽  
Sang Min Lee ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Closing Wedge ◽  
Wedge High Tibial Osteotomy

scholarly journals Survival of closing-wedge high tibial osteotomy: Good outcome in men with low-grade osteoarthritis after 10–16 years

2008 ◽  
Vol 79 (2) ◽  
pp. 230-234 ◽  
Author(s):  
Tom M van Raaij ◽  
Max Reijman ◽  
Reinoud W Brouwer ◽  
Tijs S Jakma ◽  
Jan A N Verhaar
Keyword(s):  
High Tibial Osteotomy ◽  
Low Grade ◽  
Tibial Osteotomy ◽  
Good Outcome ◽  
Closing Wedge ◽  
Wedge High Tibial Osteotomy
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