Abstract
Osteotomies around the knee for mono-compartment arthritis are still controversial. Except for a few studies with selected patients the long-term results of osteotomies are worse compared with unicondylar joint replacements. In this review a new concept including better understanding of basic biomechanical principals, patient selection, proper planning, safe intra-operative technique and stable osteosynthesis with early functional rehabilitation will be presented. Using these new principles a significant improvement in the outcome of osteotomies can be shown in short- to mid-term follow-up studies. Following this new concept the osteotomies around the knee still remain the “gold standard” for active and middle-aged patients with mono-compartment arthritis of the knee.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Newmann J, Pydisetty R, Ackroyd CE (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Joint Surg Am 75:483–498
Bonnin M, Chambat P (2004) The closed wedge valgus osteotomy at the tibia for medial gonarthritis German. Orthopade 33:135–142
Coventry MB, Ilstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy. A critical long-term study of eighty-seven cases. J Bone Joint Surg Am 75:196–201
Jakob RP, Jacobi M (2004) The closed tibia osteotomy for the treatment of the monocompartment arthritis of the knee German. Orthopade 33:143–152
Paley D, Maar DC, Herzenberg JE (1994) New concepts in high tibial osteotomy for medial compartment. Orthop Clin North Am 25:483–498
Pfeil J, Hasch E (2005) Transposition osteotomy on the knee joint German. Z Orthop Ihre Grenzgeb 143:43–64
Babis GC, An KN, Chao EY, Larson DR, Rand JA, Sim FH (2008) Upper tibia osteotomy: long term results – realignment analysis using OASIS computer software. J Orthop Sci 13:328–334
Brinkman JM, Lobenhoffer P, Agneskirchner JD, Staubli AE, Wymenga AB, van Heerwaarden RJ (2008) Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. J Bone Joint Surg Br 90:1548–1557
Hofmann S, Lobenhoffer P, Staubli A, Van Heerwarden R (2009) Osteotomies around the knee German. Orthopade 38:755–770
Lobenhoffer P, Agneskirchner J, Zoch W (2004) The medial open wedge osteotomy at the tibia with a medial plate fixateur interne German. Orthopade 33:153–160
Stahelin T, Hardegger F (2004) Incomplete supracondylar femur osteotomy German. Orthopade 33:178–184
Imhoff AB, Linke RD, Agneskirchner J (2004) Corrective osteotomy in primary varus, double varus and triple varus knee instability with cruciate ligament replacement German. Orthopade 33:201–207
Marti RK, van Heerwaarden RJ (eds) (2008) Osteotomies for posttraumatic deformities. Thieme, Stuttgart
Lobenhoffer P, Agneskirchner J, Galla M (Hrsg) (2007) Osteotomies around the knee. Thieme, Stuttgart
Pietsch M, Hofmann S (2006) Radiographic imaging at the knee joint for orthopedic surgeons German. Radiologe 46:55–64
Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A (1994) Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin N Am 25:425–465
Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227
Heller M, Taylor W, Perka C, Duda G (2003) The influence of alignment on the musculo-skeletal loading conditions at the knee. Langenbecks Arch Surg 388:291–297
Babis GC, An KN, Chao EY, Rand JA, Sim FH (2002) Double level osteotomy of the knee: a method to retain joint-line obliquity. Clinical results. J Bone Joint Surg Am 84-A:1380–1388
Hofmann S, Van Heerwaarden R (2007) Patient selection and indications for double osteotomies at the knee German. Orthop Praxis 3:143–146
Paley D, Pfeil C (2000) Principles of deformity corrections at the knee German. Orthopade 29:18–38
Saragaglia D, Mercier N, Colle PE (2009) Computer-assisted osteotomies for genu varum deformity: which osteotomy for which varus? Int Orthop 34:24–30
Strecker W (2006) Planning analysis of knee-adjacent deformities. I. Frontal plane deformities. Oper Orthop Traumatol 18:259–272
Agneskirchner J, Hurschler C, Stukenborg-Colsman C, Imhoff AB, Lobenhoffer P (2004) Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Arch Orthop Trauma Surg 3:3–9
Bonin N, Ait Si Selmi T, Dejour D, Neyret P (2004) Flexion and extension ostetomies at the knee in the adult German. Orthopade 33:193–200
Baldini A, Anderson J, Cerulli-Mariani P, Kalyvas J et al (2007) Patellofemoral evaluation after TKA: validation of new weight-bearing axial radiographic view. J Bone Joint Surg Am 89:1810–1817
Van Heerwaarden R, Van Der Haven J, Kooijman M, Wymenga A (2003) Derotation osteotomy for correction of congenital rotational lower limb deformities in adolescents and adults. Surg Tech Orthop Traumatol 55:575–585
Dejour D, Walch G, Nove-Josserand L, Guir C (1994) Factors of patellar instability: an anatomical radiographic study. Knee Surg Sports Traumatol Arthrosc 2:19–26
Rand JA, Neyret P (2005) ISAKOS meeting on management of osteoarthritis of the knee prior to total knee arthroplasty. ISAKOS Hollywood, Florida, 1–8
Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549
Agneskirchner J, Lobenhoffer P (2007) Osteotomies and ligament instability: slope corrections and combined procedures at the knee joint German. In: Lobenhoffer P, Agneskirchner J, Galler M (eds) Osteotomies around the knee. Thieme, Stuttgart, pp 79–88
König U, Widmer H, Friederich NF (2004) The clinical significance for the valgus osteotomy at the tibia in combination with cartilage repair German. Arthroskopie 17:234–238
Pape D, Seil R, Adam F, Rupp S, Kohn D, Lobenhoffer P (2004) Imaging and planning for tibia osteotomies German. Orthopade 33:122–134
Müller W (2001) High tibial osteotomy. In: European Instructional Course Lectures EFORT; K. Thorngren, P. Soucacos, F. HJroan, J Scott (eds) 5:194–206
Van Heerwaarden R, Wagenaar F, Hofmann S (2006) Doppelosteotomien von Femur und Tibia. In: Lobenhoffer P, Agneskirchner J, Galla M (Hrsg) (2007) Osteotomies around the knee. Thieme, Stuttgart, pp 107–118
Kim SJ, Koh YG, Chun YM, Kim YC, Park YS, Sung CH (2009) Medial opening wedge high-tibial osteotomy using a kinematic navigation system versus a conventional method: a 1-year retrospective, comparative study. Knee Surg Sports Traumatol Arthrosc 17:128–134
Wiehe R, Becker U, Bauer G (2007) Computer-assisted open-wedge osteotomy German. Z Orthop Unfall 145:441–447
Strecker W, Dickschas J, Harrer J, Muller M (2009) Arthroscopy prior to osteotomy in cases of unicondylar osteoarthritis. German. Orthopade 38:263–268
Baur W, Honle W, Schuh A (2005) Proximal tibial osteotomy for osteoarthritis of the knee with varus deformity. Oper Orthop Traumatol 17:326–344
Freiling D, Lobenhoffer P, Staubli A (2008) The closed wedge varus osteotomy at the femur for the treatment of the valgus gonarthritis German. Arthroskopie 21:6–14
Frey P, Muller M, Munzinger U (2008) Closing-wedge high tibial osteotomy with a modified Weber technique. Oper Orthop Traumatol 20:75–88
Hooper G, Leslie H, Burn J, Schouten R, Beci I (2005) Oblique upper tibial opening wedge osteotomy for genu varum. Oper Orthop Traumatol 17:662–673
Geiger F, Sabo D (2004) Osteotomies at the tibia with fixateur externe German. Orthopade 33:161–169
Hankemeier S, Paley D, Pape HC, Zeichen J, Gosling T, Krettek C (2004) The focal dome osteotomy at the knee German. Orthopade 33:170–177
Gaasbeek R, Sonneveld H, Van Heerwaarden R (2006) Distal tuberosity osteotomy in open wedge high tibial osteotomy can prevent patella infera: a new technique. Knee 11:457–461
Staubli AE, De SC, Babst R, Lobenhoffer P (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia–early results in 92 cases. Injury 34(Suppl 2):55–62
Franco V, Cipolla M, Gerullo G, Gianni E, Puddu G (2004) Open wedge osteotomy of the distal femur in the valgus knee German. Orthopade 33:185–192
Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69:332–354
Jenny JY, Tavan A, Jenny G, Kehr P (1998) Long-term survival rate of tibial osteotomies for valgus gonarthrosis French. Rev Chir Orthop Reparatrice Appar Mot 84:350–357
Salzmann GM, Ahrens P, Naal FD, El-Azab H, Spang JT, Imhoff AB, Lorenz S (2009) Sporting activity after high tibial osteotomy for the treatment of medial compartment knee osteoarthritis. Am J Sports Med 37:312–318
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 EFORT
About this chapter
Cite this chapter
Hofmann, S., Lobenhoffer, P., Staubli, A., Van Heerwaarden, R. (2011). Osteotomies Around the Knee. In: Bentley, G. (eds) European Instructional Lectures. European Instructional Lectures, vol 11. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18321-8_14
Download citation
DOI: https://doi.org/10.1007/978-3-642-18321-8_14
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-18320-1
Online ISBN: 978-3-642-18321-8
eBook Packages: MedicineMedicine (R0)