Importance of osteotomy around to the knee for medial gonarthritis. Indications, technique and results

Abstract

Frontal plane deformities result in significant overload of the (ipsilateral) affected compartment of the knee and in rapid progression of osteoarthritis. The indication for osteotomy around the knee is related mainly to the constitutional metaphyseal deformity in the frontal plane. Exact analysis and planning based on a long-leg standing radiograph is mandatory. Valgus high tibial osteotomy can be performed safely and atraumatically by biplanar open-wedge osteotomy from medial using a specific plate-fixator. A new technique of closed wedge biplanar distal femur osteotomy with fixation by a new plate fixator is also presented. Our multicenter follow-up study with 533patients revealed good functional outcome scores with a small complication rate. The subjective ratings were better than in comparable groups with unicondylar knee replacement and with total knee arthroplasty. Metaanalysis from the literature have proven good long-term results of osteotomy around the knee. Osteotomy around the knee results in good middle-term and long-term results if the indication criteria are respected and a specific surgical technique is used.