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Dome-shaped high tibial osteotomy: a long-term follow-up study
Hongsen Chiang1, Hsi-Ching Hsu, Ching-Chuan Jiang
1Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
Summary
Dome-shaped high tibial osteotomy (HTO) offers durable correction for medial knee osteoarthritis, maintaining alignment and function over 15 years. This procedure helps avoid patella baja, simplifying future knee replacement surgery.
Area of Science:
- Orthopedic surgery
- Knee biomechanics
- Osteoarthritis treatment
Background:
- High tibial osteotomy (HTO) is a common treatment for knee osteoarthritis.
- Durability and complications of HTO remain debated.
- A novel dome-shaped HTO technique was previously introduced.
Purpose of the Study:
- To analyze the long-term follow-up results of the novel dome-shaped HTO technique.
- To evaluate the durability and effectiveness of dome-shaped HTO for medial gonarthrosis.
Main Methods:
- 25 varus knees in 22 patients with medial gonarthrosis were treated.
- A calibrated cutting jig, rigid external fixation, and early joint motion were used.
- 16 patients (19 knees) were followed up for 13-16 years (mean 15 years).
Main Results:
- Initial average valgus correction of 12.4 degrees decreased to 7.8 degrees at 5 years.
- Hospital for Special Surgery knee scores showed deterioration over time.
- Loss of correction was not correlated with initial alignment or knee scores.
- Joint motion and patellar position remained stable, without developing patella baja.
Conclusions:
- Dome-shaped HTO is a durable procedure for medial gonarthrosis.
- It acts as a 'time-buying' procedure, delaying the need for arthroplasty.
- This technique may prevent patella baja, simplifying subsequent prosthetic surgery.
