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[Medial opening wedge high tibial osteotomy].

P Niemeyer1,2, A Stöhr3, M Köhne3

  • 1Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland. phniemeyer@gmail.com.

Operative Orthopadie Und Traumatologie
|June 24, 2017
PubMed
Summary

Medial opening wedge high tibial osteotomy (OW-HTO) can effectively reduce load in medial knee osteoarthritis patients. Despite potential complications, standardized OW-HTO offers good outcomes and patient satisfaction when indicated properly.

Keywords:
Genu varumJoint instabilityKnee jointOsteoarthritis, kneeOsteotomy

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Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Knee Osteoarthritis Research

Background:

  • Medial knee osteoarthritis often presents with varus malalignment.
  • Varus deformity can be exacerbated by complex ligamentous laxity, affecting the posterolateral complex.
  • Accurate patient selection is crucial for successful surgical intervention.

Purpose of the Study:

  • To evaluate the efficacy of medial opening wedge high tibial osteotomy (OW-HTO) in reducing load on the medial compartment of the knee.
  • To assess the outcomes of OW-HTO in patients with medial knee osteoarthritis and varus malalignment.
  • To determine the effectiveness of OW-HTO in unloading the posterolateral complex in cases of varus deformity with ligamentous laxity.

Main Methods:

  • The study details the surgical technique for OW-HTO, including medial incision, pes anserinus preparation, and biplane osteotomy.
  • Angular-stable plate fixation is employed for stabilization.
  • Postoperative management emphasizes early weight-bearing possibilities with orthoses, though longer unloading may be needed for concomitant therapies.

Main Results:

  • The medial opening wedge high tibial osteotomy (OW-HTO) technique demonstrates good results and high patient satisfaction when performed with correct indications and a standardized approach.
  • A relatively high statistical complication rate was observed.
  • Outcomes tend to be less favorable in patients with a body mass index > 30 and advanced stages of osteoarthritis.

Conclusions:

  • Medial opening wedge high tibial osteotomy (OW-HTO) is an effective procedure for specific knee conditions.
  • Standardization of surgical technique is paramount for achieving favorable outcomes.
  • Patient factors like BMI and osteoarthritis severity influence the success of OW-HTO.