High Tibial Osteotomy For Osteoarthritis Research Articles

A prospective and retrospective study of the outcome of high tibial osteotomy in osteoarthritis of the knee with varus deformity

A prospective and retrospective study of the outcome of high tibial osteotomy in osteoarthritis of the knee with varus deformity

A Prospective Study of the Outcome of High Tibial Osteotomy in Osteoarthritis of Knee with varus Deformity

A Prospective Study of the Outcome of High Tibial Osteotomy in Osteoarthritis of Knee with varus Deformity

Clinical Effect of High Tibial Osteotomy for Osteoarthritis of the Medial Compartment of the Knee

Clinical Effect of High Tibial Osteotomy for Osteoarthritis of the Medial Compartment of the Knee

Early Results of High Tibial Osteotomy for Osteoarthritis in Mongolia

Objectives: The objectives of this study were to examine the reproducibility of the surgical correction and pain relief following high tibial osteotomy for osteoarthritis. Methods: Twenty-seven patients who underwent high tibial osteotomy at The First Central Hospital of Mongolia were included. Patients divided into three groups based on their osteoarthritis grade using the Kellgren Lawrence classification. The weight-bearing line and medial proximal tibial angle were used for preoperative planning to assess postoperative correction. Oxford knee scores were used to assess knee pain and function. Results: The weight-bearing line and medial proximal tibial angle measurements at both postoperative time intervals were significantly different from the preoperative values (p<.001) but were not significantly different from each other. The Oxford knee scores were 31.54±6.3 preoperatively, 34.82±4.3 at two months after the surgery and improved to 40.89±2.7 six months after the surgery. Statistically significant successive improvements in scores were observed at each time interval (p<.001). Conclusion: High tibial osteotomy can be done with rigid internal fixation and can improve function and reduce pain in Mongolian patients with early arthritis without affecting joint range of motion.

Closed wedge high tibial osteotomy for osteoarthritis caused by the treatment of distal femoral osteosarcoma; a case report

Closed wedge high tibial osteotomy for osteoarthritis caused by the treatment of distal femoral osteosarcoma; a case report

Clinical results of new hemi-open closed wedge high tibial osteotomy for osteoarthritis of the knee

Clinical results of new hemi-open closed wedge high tibial osteotomy for osteoarthritis of the knee

Results of High Tibial Osteotomy for Osteoarthritis of the Knee

Results of High Tibial Osteotomy for Osteoarthritis of the Knee

Unicompartmental Knee Arthroplasty for Undercorrected Knees after High Tibial Osteotomy in Osteoarthritis of the Knee

Unicompartmental Knee Arthroplasty for Undercorrected Knees after High Tibial Osteotomy in Osteoarthritis of the Knee

Fixation stability of opening- versus closing-wedge high tibial osteotomy

Valgus high tibial osteotomy for osteoarthritis of the medial compartment of the knee can be performed using medial opening- and lateral closing-wedge techniques. The latter have been thought to offer greater initial stability. We measured and compared the stability of opening- and closing-wedge osteotomies fixed by TomoFix plates using radiostereometry in a series of 42 patients in a prospective, randomised clinical trial. There were no differences between the opening- and closing-wedge groups in the time to regain knee function and full weight-bearing. Pain and knee function were significantly improved in both groups without any differences between them. All the osteotomies united within one year. Radiostereometry showed no clinically relevant movement of bone or differences between either group. Medial opening-wedge high tibial osteotomy secured by a TomoFix plate offers equal stability to a lateral closing-wedge technique. Both give excellent initial stability and provide significantly improved knee function and reduction in pain, although the opening-wedge technique was more likely to produce the intended correction.

Inverted V-shaped high tibial osteotomy compared with closing-wedge high tibial osteotomy for osteoarthritis of the knee

We compared the results ten years after an inverted V-shaped high tibial osteotomy with those of a historical series of conventional closing-wedge osteotomies. The closing-wedge series consisted of 56 knees in 51 patients with a mean follow-up of 11 years (10 to 15). The inverted V-shaped osteotomy was evaluated in 48 knees in 43 patients at a mean follow-up of 14 years (10 to 19). All the patients were scored using the Japanese Orthopaedic Association rating scale for osteoarthritis of the knee and radiological assessment. The pre-operative grade of osteoarthritis was similar in both groups. Post-operatively, the knee function score was graded as satisfactory in 63% (35) of the closing-wedge group but in 89% (43) of the inverted V-shaped osteotomy group. Post-operative radiological examination showed that delayed union and loss of correction occurred more often after a closing-wedge osteotomy than after an inverted V-shaped procedure. Our study suggests that the inverted V-shaped osteotomy may offer more dependable long-term results than traditional closing-wedge osteotomy.

Clinical result of high tibial osteotomy for osteoarthritis of the knee

Clinical result of high tibial osteotomy for osteoarthritis of the knee

Increase in range of knee motion to obtain floor sitting after high tibial osteotomy for osteoarthritis

In order to obtain better range of motion in knees with osteoarthritis, medial and lateral parapatellar retinaculo-capsular release operations were performed at the time of high tibial osteotomy, with fixation using dual plating on medial compartmental knee osteoarthritis (29 knees) or spontaneous osteonecrosis of the medial femoral condyle (15 knees). At removal of the blade plate, 1 to 2 years after the initial osteotomy, the same release procedures were performed together with resection of adhesive soft tissue and resection of osteophytes, which were obstacles to full flexion. A grading system (Grade 0–3) was proposed to evaluate the duration (min) of formal floor sitting. After these procedures, the patients were able to sit on the floor with 155–165° of flexion for more than 30 min (Grade 3) in 20 knees, for 10–29 min (Grade 2) in seven, for less than 10 min (Grade 1) in nine and were unable to sit on the floor (Grade 0) in eight knees. Maximum knee flexion and total range of motion were 142±8.4° and 137±11° before and 152±6.6° and 151±7.4° after surgery, respectively. The American Knee Society Knee Score and Function Score were 61±17 and 46±16 before, and 97±5 ( P<0.0001) and 91±13 ( P<0.0001) after surgery at the final follow-up, respectively. The femoro-tibial angle in standing with one leg was 183±6° (3° of anatomical varus angulation) before and 170±3° ( P<0.0001) (10° of anatomical valgus angulation) after surgery.

Open-wedge osteotomy of the proximal tibia with hemicallotasis

Conventional high tibial osteotomy for osteoarthritis of the medial compartment of the knee with closed-wedge or dome osteotomy (DMO) may produce shortening of the patellar tendon and loss of inclination of the proximal tibial plateau or of the offset of the tibial condyle relative to its bony axis. This can make subsequent total knee arthroplasty technically demanding. We undertook a prospective study comparing these changes after DMO with those after using open-wedge osteotomy hemicallotasis (HCO). A total of 50 knees with arthritis of the medial compartment in 46 consecutive patients was randomly allocated to either DMO or HCO. There were no significant differences between the groups with regard to age, gender, femorotibial angle before operation or the angle of correction. Radiological studies showed that HCO caused little change in the length of the patellar tendon or the inclination angle of the tibial plateau, while after DMO both gradually decreased. The degree of tibial condylar offset increased in both groups, but less so in the HCO group.

The change of the bilateral lower extremity alignment after high tibial osteotomy in osteoarthritis of the knee

The change of the bilateral lower extremity alignment after high tibial osteotomy in osteoarthritis of the knee

Long-term Results after High Tibial Osteotomy for Osteoarthritis of the Knee

Long-term Results after High Tibial Osteotomy for Osteoarthritis of the Knee

High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up

On three occasions we have reviewed a series of knees after high tibial osteotomy for osteoarthritis: 99 were reviewed at one to two years; 81 at a mean of 5.7 years; and 65 at a mean of 11.9 years. At one to two years and at 5.7 years over 50% were good and over 75% acceptable. At 11.9 years, 43% were good and 60% acceptable. We determined the mechanical axis through the knee in maximum varus and maximum valgus; significantly better results were found if a mean angulation of 3 degrees to 7 degrees of valgus had been achieved at operation. We also measured intercondylar distances under varus and valgus stress, and found no significant lateral compartment narrowing. The best results were seen in knees with pre-operative grade I or grade II osteoarthritis and valgus deviation after osteotomy.

Total knee arthroplasty following high tibial osteotomy for osteoarthritis

The authors assessed the effect of proximal tibial osteotomy on the results of a subsequent total knee arthroplasty. A retrospective, clinical and radiographic analysis was carried out between a study group of 39 patients with 42 total knee arthroplasties following osteotomy and a control group of 39 patients with 41 primary arthroplasties. Outcome was assessed using the Hospital for Special Surgery (HSS) knee score, pain, function, range of motion, and radiographic evaluation. The follow-up period averaged 37 months (range, 24–50 months). The study group had 88% good or excellent results using the HSS score, compared to 90% in the control group. Function and pain improved equally in both groups. The control group had, on average, 14° greater range of motion (115° v. 101°) after arthroplasty. The control group had, on average, posterior inclination of the tibial plateau of 7° before operation and 3° after operation; the corresponding values in the study group were 2° and 1°. Using the HSS score and pain and function as parameters, previous, osteotomy does not seem to affect the outcome of total knee arthroplasty. Conversely, range of motion following arthroplasty appears to be less in those with prior osteotomy. In addition, a high tibial osteotomy may alter the inclination of the tibial plateau.

Experience of Domed High Tibial Osteotomy in Osteoarthritis of the Knee joint

Post-operative results are evaluated in twelve knee joints of the twelve patients with knee disorders (eleven of osteoarthritis and one of osteonecrosis) treated surgically by domed high tibial osteotomy. Followed-up period are ranged from eight to twenty months. There were varus deformity in all the cases except for one. Pain and effusion were effectively relieved post-operatively in all of them. They showed a satisfaction with the postoperative results. In the post-operative course, valgus position obtained by osteotomy is found to return to varus posion with decrease of four to seven degrees of femoro-tibial angle (FTA). So carefull management will be necessary to avoid recurring of varus deformity after surgery untill bony fusion is completed at the osteotomy site.

Results of surgical treatment for non-union after high tibial osteotomy in osteoarthritis of the knee.

In a series of 280 high tibial osteotomies performed for osteoarthritis of the knee between 1969 and 1975, there were ten cases of pseudarthrosis, an incidence of 3.6 per cent. These ten knees (and an additional two that were referred to us) were reoperated on. In most cases the pseudarthrosis was resected and stabilized with the Charnley transfixation-compression method. Other procedures involved resection without compression (one knee), compression blade-plate fixation, and arthroplasty with a hinge endoprosthesis. All osteotomies healed eventually with the knee in satisfactory position. In spite of the initial non-union and repeated operation, all twelve patients eventually had satisfactory correction of the preosteotomy deformity, and none had a loss in walking ability. All but two patients had freedom from pain. We concluded that patients with non-union following high tibial osteotomy for osteoarthritis of the knee should undergo resection of the pseudarthrosis and transfixation compression as the treatment of choice. Endoprosthetic replacement then can be used as a salvage procedure if it is needed.

Experience of High Tibial Osteotomy for Osteo-arthritis of The Knee

Experience of High Tibial Osteotomy for Osteo-arthritis of The Knee