Joint preservation procedures: osteotomies about the knee

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Sports Medicine

Background:

• Osteotomies are regaining interest for knee joint preservation.
• They address alignment, ligamentous stability, and cartilage health.

Purpose of the Study:

• To review the role of osteotomies in knee alignment correction and joint preservation.
• To discuss various osteotomy techniques for different knee compartments and instabilities.

Main Methods:

• Review of common osteotomy procedures: Medial opening wedge high tibial osteotomy (MOW-HTO), lateral closing wedge high tibial osteotomy (LCW-HTO), distal femoral osteotomy (DFO).
• Discussion of sagittal plane osteotomies for ligamentous instability (ACL/PCL deficiencies) and tibial tubercle osteotomies (TTO) for patellofemoral issues.
• Exploration of double-level osteotomies for complex cases.

Main Results:

• Osteotomies effectively correct coronal and sagittal plane alignment.
• Procedures can preserve cartilage, improve ligamentous stability, and offload affected compartments.
• Tibial tubercle osteotomies aid in patellofemoral malalignment and cartilage preservation.

Conclusions:

• Knee osteotomies are crucial for limb alignment and cartilage protection, potentially delaying arthroplasty.
• These procedures offer significant benefits for young, active patients seeking to preserve their knee joint.