Skip to main content

Osteotomies Around the Knee

  • Chapter
  • First Online:
European Instructional Lectures

Part of the book series: European Instructional Lectures ((EICL,volume 11))

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 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

    Google Scholar 

  2. Bonnin M, Chambat P (2004) The closed wedge valgus osteotomy at the tibia for medial gonarthritis German. Orthopade 33:135–142

    Article  PubMed  CAS  Google Scholar 

  3. 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

    PubMed  CAS  Google Scholar 

  4. Jakob RP, Jacobi M (2004) The closed tibia osteotomy for the treatment of the monocompartment arthritis of the knee German. Orthopade 33:143–152

    Article  PubMed  CAS  Google Scholar 

  5. Paley D, Maar DC, Herzenberg JE (1994) New concepts in high tibial osteotomy for medial compartment. Orthop Clin North Am 25:483–498

    PubMed  CAS  Google Scholar 

  6. Pfeil J, Hasch E (2005) Transposition osteotomy on the knee joint German. Z Orthop Ihre Grenzgeb 143:43–64

    Article  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. Hofmann S, Lobenhoffer P, Staubli A, Van Heerwarden R (2009) Osteotomies around the knee German. Orthopade 38:755–770

    Article  PubMed  CAS  Google Scholar 

  10. 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

    Article  PubMed  CAS  Google Scholar 

  11. Stahelin T, Hardegger F (2004) Incomplete supracondylar femur osteotomy German. Orthopade 33:178–184

    Article  PubMed  CAS  Google Scholar 

  12. 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

    Article  PubMed  CAS  Google Scholar 

  13. Marti RK, van Heerwaarden RJ (eds) (2008) Osteotomies for posttraumatic deformities. Thieme, Stuttgart

    Google Scholar 

  14. Lobenhoffer P, Agneskirchner J, Galla M (Hrsg) (2007) Osteotomies around the knee. Thieme, Stuttgart

    Google Scholar 

  15. Pietsch M, Hofmann S (2006) Radiographic imaging at the knee joint for orthopedic surgeons German. Radiologe 46:55–64

    Article  PubMed  CAS  Google Scholar 

  16. 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

    CAS  Google Scholar 

  17. 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

    PubMed  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. 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

    PubMed  Google Scholar 

  20. Hofmann S, Van Heerwaarden R (2007) Patient selection and indications for double osteotomies at the knee German. Orthop Praxis 3:143–146

    Google Scholar 

  21. Paley D, Pfeil C (2000) Principles of deformity corrections at the knee German. Orthopade 29:18–38

    PubMed  CAS  Google Scholar 

  22. Saragaglia D, Mercier N, Colle PE (2009) Computer-assisted osteotomies for genu varum deformity: which osteotomy for which varus? Int Orthop 34:24–30

    Article  PubMed  Google Scholar 

  23. Strecker W (2006) Planning analysis of knee-adjacent deformities. I. Frontal plane deformities. Oper Orthop Traumatol 18:259–272

    Article  PubMed  Google Scholar 

  24. 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

    Google Scholar 

  25. 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

    Article  PubMed  CAS  Google Scholar 

  26. 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

    Article  PubMed  Google Scholar 

  27. 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

    Google Scholar 

  28. 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

    Article  PubMed  CAS  Google Scholar 

  29. Rand JA, Neyret P (2005) ISAKOS meeting on management of osteoarthritis of the knee prior to total knee arthroplasty. ISAKOS Hollywood, Florida, 1–8

    Google Scholar 

  30. 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

    PubMed  CAS  Google Scholar 

  31. 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

    Google Scholar 

  32. 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

    Article  Google Scholar 

  33. Pape D, Seil R, Adam F, Rupp S, Kohn D, Lobenhoffer P (2004) Imaging and planning for tibia osteotomies German. Orthopade 33:122–134

    Article  PubMed  CAS  Google Scholar 

  34. Müller W (2001) High tibial osteotomy. In: European Instructional Course Lectures EFORT; K. Thorngren, P. Soucacos, F. HJroan, J Scott (eds) 5:194–206

    Google Scholar 

  35. 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

    Google Scholar 

  36. 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

    Article  PubMed  CAS  Google Scholar 

  37. Wiehe R, Becker U, Bauer G (2007) Computer-assisted open-wedge osteotomy German. Z Orthop Unfall 145:441–447

    Article  PubMed  CAS  Google Scholar 

  38. Strecker W, Dickschas J, Harrer J, Muller M (2009) Arthroscopy prior to osteotomy in cases of unicondylar osteoarthritis. German. Orthopade 38:263–268

    Article  PubMed  CAS  Google Scholar 

  39. Baur W, Honle W, Schuh A (2005) Proximal tibial osteotomy for osteoarthritis of the knee with varus deformity. Oper Orthop Traumatol 17:326–344

    Article  PubMed  Google Scholar 

  40. 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

    Article  Google Scholar 

  41. Frey P, Muller M, Munzinger U (2008) Closing-wedge high tibial osteotomy with a modified Weber technique. Oper Orthop Traumatol 20:75–88

    Article  PubMed  Google Scholar 

  42. 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

    Article  PubMed  Google Scholar 

  43. Geiger F, Sabo D (2004) Osteotomies at the tibia with fixateur externe German. Orthopade 33:161–169

    Article  PubMed  CAS  Google Scholar 

  44. 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

    Article  PubMed  CAS  Google Scholar 

  45. 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

    Article  Google Scholar 

  46. 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

    Article  Google Scholar 

  47. 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

    Article  PubMed  CAS  Google Scholar 

  48. 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

    PubMed  CAS  Google Scholar 

  49. 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

    PubMed  CAS  Google Scholar 

  50. 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

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Siegfried Hofmann .

Editor information

Editors and Affiliations

Rights and permissions

Reprints 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)

Publish with us

Policies and ethics