scholarly journals High tibial osteotomy in varus knees: indications and limits

Joints ◽  
2016 ◽  
Vol 04 (02) ◽  
pp. 098-110 ◽  
Author(s):  
Marco Loia ◽  
Stefania Vanni ◽  
Federica Rosso ◽  
Davide Bonasia ◽  
Matteo Bruzzone ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Proximal Tibiofibular Joint ◽  
Range Of Movement ◽  
Opening Wedge ◽  
Instability Range ◽  
Tibiofibular Joint ◽  
Wedge High Tibial Osteotomy

Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years.The aim of this study is to review the literature on OWHTO, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at midterm follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty).

scholarly journals EVALUATION OF OUTCOME OF MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY FOR UNICOMPARTMENTAL KNEE OSTEOARTHRITIS

2020 ◽  
pp. 1-4
Author(s):  
R. N. Shewale ◽  
Ketan J. Khatri
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Outcome ◽  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Functional Score ◽  
Tibial Osteotomy ◽  
Knee Score ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy ◽  
The Mean

Background: Osteoarthritis is often found in weight-bearing joints, the knee being the most common site. Most patients of symptomatic osteoarthritis of knee are associated with varus malalignment that is causative or contributory to painful arthritis. Correcting the malalignment of the knee relieves symptoms by transferring the functional load to the unaffected compartment. The goal of the treatment is to relieve medial compartment knee pain and slow down the arthritic progression. We report the outcome of a simple technique of medial opening wedge high tibial osteotomy in treating the medial compartment osteoarthritis of the knee. Materials and method: A prospective interventional study was carried out over a period of 2 years from November 2017 to October 2019 in a sample size of randomly selected 41 patients having unilateral knee osteoarthritis. All patients after a proper preoperative assessment underwent high tibial osteotomy and the outcome was evaluated using knee society scoring system. Results: The age of the patients ranged from 40 – 65 years with a mean age of 51 years, 13 were males and 28 were females showing female predominance (68.2%). The mean knee score and the mean functional score of the patients before surgery were 60 and 61.95 respectively and post operatively at the end of 6 months the knee score and functional score was 77 and 80.53 respectively. By the end of 6 months out of 41 patients, 12 patients (29.2%) had excellent functional outcome, 18 patients (43.90%) had good functional outcome, 09 patients (21.95%) had fair functional outcome while only 02 patients (04.87%) had poor functional outcome. Conclusions: The present study shows that HTO is a good option in isolated medial compartment OA of knee. Significant increase in the knee score and functional score was found after high tibial osteotomy for the patients of osteoarthritis with varus deformity. Success of high tibial osteotomy relies on appropriate patient selection, proper osteotomy type and precise surgical technique.

Medial Opening Wedge High Tibial Osteotomy for Medial Compartment Overload/Arthritis in the Varus Knee

2014 ◽  
Vol 42 (3) ◽  
pp. 690-698 ◽  
Author(s):  
Davide Edoardo Bonasia ◽  
Federico Dettoni ◽  
Gabriele Sito ◽  
Davide Blonna ◽  
Antongiulio Marmotti ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Varus Knee ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy

Medial Opening Wedge High Tibial Osteotomy With Early Full Weight Bearing

2009 ◽  
Vol 25 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Ryohei Takeuchi ◽  
Hiroyuki Ishikawa ◽  
Masato Aratake ◽  
Haruhiko Bito ◽  
Izumi Saito ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy

Proximal tibiofibular joint changes after closed-wedge high tibial osteotomy. Are they relevant?

The Knee ◽  
2020 ◽  
Vol 27 (5) ◽  
pp. 1585-1592
Author(s):  
Lara Gil-Melgosa ◽  
Andrés Valentí ◽  
Álvaro Suárez ◽  
Verónica Montiel
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Proximal Tibiofibular Joint ◽  
Closed Wedge ◽  
Tibiofibular Joint ◽  
Wedge High Tibial Osteotomy

Simultaneous bilateral opening-wedge high tibial osteotomy with early full weight-bearing exercise

2008 ◽  
Vol 16 (11) ◽  
pp. 1030-1037 ◽  
Author(s):  
Ryohei Takeuchi ◽  
Masato Aratake ◽  
Haruhiko Bito ◽  
Izumi Saito ◽  
Ken Kumagai ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy

Radiographic Evaluation of Medial Opening-Wedge High Tibial Osteotomy Using a New Internal Fixator with a Wedge-Shaped Spacer Block

2020 ◽  
Author(s):  
Shinichiro Okimura ◽  
Atsushi Teramoto ◽  
Kota Watanabe ◽  
Satoshi Nuka ◽  
Tomoaki Kamiya ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Case Series ◽  
Internal Fixator ◽  
Radiographic Evaluation ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Case Series Study ◽  
Significant Difference ◽  
Wedge High Tibial Osteotomy

AbstractWe developed a new internal fixator: a rigid T-shaped plate with locking screws and wedge-shaped spacer block for high tibial osteotomy. The purpose of the present study was to evaluate the radiographic outcome of opening-wedge high tibial osteotomy (OWHTO) using this new internal fixator. Sixty OWHTOs were performed in patients with medial compartment osteoarthritis and varus deformity (28 males and 23 females). Patients' mean age was 60.4 years. Preoperative and postoperative radiographs were obtained. The paired t-test was used to evaluate the differences over time with respect to radiographic variables. Union of the osteotomy gap was obtained in all patients, and no implant breakage was found. On anterior–posterior radiographs, a significant difference was observed (p < 0.01) between the preoperative and postoperative mean values of femorotibial angles (179.6 ± 3.2 vs. 170.6 ± 2.5 degrees), weight-bearing line ratios (23.8 ± 13.5 vs. 60.5 ± 11.5%), anatomical medial proximal tibial angles (84.8 ± 2.5 vs. 91.0 ± 2.6 degrees), and joint line coverage angles (3.6 ± 2.0 vs. 2.4 ± 1.7 degrees). On lateral radiographs, posterior tibial slopes were 11.5 ± 3.9 degrees preoperatively and 12.2 ± 4.0 degrees postoperatively (p < 0.01), and Insall–Salvati ratios were 1.04 ± 0.12 preoperatively and 1.06 ± 0.13 postoperatively (p = 0.24). Performing OWHTO using a new internal fixator with a wedge-shaped spacer achieves adequate correction of lower limb alignment without implant-related complications. This is a Level IV, case series study.

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