Proximal tibial osteotomy: where did you go?

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering

Background:

• Knee osteotomy prevalence has decreased, attributed to improved total knee arthroplasty (TKA) outcomes and surgeon preference.
• Current TKA may not offer sufficient long-term durability for younger, active patients requiring replacements lasting decades.

Purpose of the Study:

• To advocate for the continued and earlier use of knee osteotomy.
• To highlight the limitations of comparing TKA with osteotomy outcomes due to differing patient cohorts and timelines.

Main Methods:

• Literature review and clinical experience analysis.
• Discussion of comparative outcome challenges between primary TKA and post-osteotomy TKA.

Main Results:

• Knee osteotomy is underutilized despite potential benefits for specific patient groups.
• Standard comparisons between TKA and osteotomy are often inappropriate, masking osteotomy's value.

Conclusions:

• Knee osteotomy remains a viable option, particularly when performed earlier in active patients.
• Future advancements in biologic resurfacing and technology may enhance osteotomy performance, warranting its continued consideration.