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The Role of Knee Osteotomy in the Setting of Articular Cartilage Repair

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Cartilage Repair Strategies

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Abstract

Knee osteotomies were initially used to treat degenerative arthritis of the knee. Over time, indications have become stricter, and now knee osteotomies are primarily used to correct varus or valgus malalignment associated with unicompartmental osteoarthritis. Knee osteotomies redistribute the load from the diseased compartment to the more normal compartment. Knee osteotomies can be used for primary treatment of knee pain and tibiofemoral malalignment, or they can be combined with cartilage repair procedures to provide a chondroprotective effect. By correcting the tibiofemoral malalignment, joint reactive forces are decreased in the diseased compartment, allowing for improved survival of meniscal transplants and cartilage resurfacing procedures.

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References

  1. Jackson JP. Osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 1958;40B:826.

    Google Scholar 

  2. Jackson JP, Waugh W. Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 1961;43-B:746–751.

    PubMed  CAS  Google Scholar 

  3. Wardle EN. Osteotomy of the tibia and fibula. Surg Gynecol Obstet 1962;115:61–64.

    PubMed  CAS  Google Scholar 

  4. Gariepy G. Genu varum treated by high tibial osteotomy. In Proceedings of the Joint Meeting of the Orthopaedic Associations. JBJS 1964;46-B:783–784.

    Google Scholar 

  5. Coventry MB. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am 1965;47:984–990.

    PubMed  CAS  Google Scholar 

  6. Berman AT, Bosacco SJ, Kirshner S, Avolio A Jr. Factors influencing long-term results in high tibial osteotomy. Clin Orthop Relat Res 1991;272:192–198.

    PubMed  Google Scholar 

  7. Coventry MB. Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Sur gAm 1973;55:23–48.

    CAS  Google Scholar 

  8. Rinonapoli E, Mancini GB, Corvaglia A, Musiello S. Tibial osteotomy for varus gonarthrosis. A 10-to 21-year followup study. Clin Orthop Relat Res 1998;353:185–193.

    Article  PubMed  Google Scholar 

  9. Marti RK, Verhagen RA, Kerkhoffs GM, Moojen TM. Proximal tibial varus osteotomy. Indications, technique, and 5-to 21-yr results. J Bone Joint Surg Am 2001;83-A:164–170.

    PubMed  CAS  Google Scholar 

  10. Papachristou G. Photoelastic study of the internal and contact stresses on the knee joint before and after osteotomy. Arch Orthop Trauma Surg 2004;124:288–297.

    Article  PubMed  Google Scholar 

  11. Kettelkamp DB, Wenger DR, Chao EY, Thompson C. Results of proximal tibial osteotomy. The effects of tibiofemoral angle, stance-phase flexion-extension, and medial-plateau force. J Bone Joint Surg Am 1976;58:952–960.

    PubMed  CAS  Google Scholar 

  12. Harris WR, Kostuik JP. High tibial osteotomy for osteo-arthritis of the knee. J Bone Joint Surg Am 1970;52:330–336.

    PubMed  CAS  Google Scholar 

  13. Maquet P. The treatment of choice in osteoarthritis of the knee. Clin Orthop Relat Res 1985;192:108–112.

    PubMed  Google Scholar 

  14. Tjornstrand BA, Egund N, Hagstedt BV. High tibial osteotomy: a 7-yr clinical and radiographic follow-up. Clin Orthop Relat Res 1981;160:124–136.

    PubMed  Google Scholar 

  15. Schultz W, Gobel D. Articular cartilage regeneration of the knee joint after proximal tibial valgus osteotomy: a prospective study of different intraand extra-articular operative techniques. Knee Surg Sports Traumatol Arthrosc 1999;7:29–36.

    Article  PubMed  CAS  Google Scholar 

  16. Koshino T, Wada S, Ara Y, Saito T. Regeneration of degenerated articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis of the knee. Knee 2003; 10: 229–236.

    Article  PubMed  Google Scholar 

  17. Akamatsu Y, Koshino T, Saito T, Wada J. Changes in osteosclerosis of the osteoarthritic knee after high tibial osteotomy. Clin Orthop Relat Res 1997;334:207–214.

    Article  PubMed  Google Scholar 

  18. Wei L, Hjerpe A, Brismar BH, Svensson O. Effect of load on articular cartilage matrix and the development of guinea-pig osteoarthritis. Osteoarthritis Cartilage 2001;9:447–453.

    Article  PubMed  CAS  Google Scholar 

  19. Matsui N, Moriya H, Kitahara H. The use of arthroscopy for follow-up in knee joint surgery. Orthop Clin North Am 1979; 10:697–708.

    PubMed  CAS  Google Scholar 

  20. Odenbring S, Egund N, Lindstrand A, Lohmander LS, Willen H. Cartilage regeneration after proximal tibial osteotomy for medial gonarthrosis. An arthroscopic, roentgenographic, and histologic study. Clin Orthop Relat Res 1992;277:210–216.

    PubMed  Google Scholar 

  21. Akizuki S, Yasukawa Y, Takizawa T. Does arthroscopic abrasion arthroplasty promote cartilage regeneration in osteoarthritic knees with eburnation? A prospective study of high tibial osteotomy with abrasion arthroplasty vs high tibial osteotomy alone. Arthroscopy 1997;13:9–17.

    Article  PubMed  CAS  Google Scholar 

  22. Wakabayashi S, Akizuki S, Takizawa T, Yasukawa Y. A comparison of the healing potential of fibrillated cartilage vs eburnated bone in osteoarthritic knees after high tibial osteotomy: an arthroscopic study with 1-yr follow-up. Arthroscopy 2002; 18:272–278.

    Article  PubMed  Google Scholar 

  23. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 1979; 10:585–608.

    PubMed  CAS  Google Scholar 

  24. McDermott AG, Langer F, Pritzker KP, Gross AE. Fresh small-fragment osteochondral allografts. Long-term follow-up study on first 100 cases. Clin Orthop Relat Res 1985;197:96–102.

    PubMed  Google Scholar 

  25. Hangody L, Fules P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: 10 yr of experimental and clinical experience. J Bone Joint Surg Am 2003;85-A(suppl 2):25–32.

    PubMed  Google Scholar 

  26. Ghazavi MT, Pritzker KP, Davis AM, Gross AE. Fresh osteochondral allografts for post-traumatic osteochondral defects of the knee. J Bone Joint Surg Br 1997;79:1008–1013.

    Article  PubMed  CAS  Google Scholar 

  27. Beaver RJ, Mahomed M, Backstein D, et al. Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis. J Bone Joint Surg Br 1992;74:105–110.

    PubMed  CAS  Google Scholar 

  28. Shasha N, Krywulak S, Backstein D, Pressman A, Gross AE. Long-term follow-up of fresh tibial osteochondral allografts for failed tibial plateau fractures. J Bone Joint Surg Am 2003; 85-A(suppl 2):33–39.

    PubMed  Google Scholar 

  29. Aubin PP, Cheah HK, Davis AM, Gross AE. Long-term followup of fresh femoral osteochondral allografts for posttraumatic knee defects. Clin Orthop Relat Res 2001;391(suppl):S318–S327.

    Article  PubMed  Google Scholar 

  30. Oakeshott RD, Farine I, Pritzker KPH, Langer F, Gross AE. A clinical and histologic analysis of failed fresh osteochondral allografts. Clin Orthop 1988;233:283–294.

    PubMed  Google Scholar 

  31. Cameron JC, Saha S. Meniscal allograft transplantation for unicompartmental arthritis of the knee. Clin Orthop Relat Res 1997;337:164–171.

    Article  PubMed  Google Scholar 

  32. Verdonk R. Alternative treatments for meniscal injuries. J Bone Joint Surg Br 1997;79:866–873.

    Article  PubMed  CAS  Google Scholar 

  33. Graf KW Jr, Sekiya JK, Wojtys EM. Long-term results after combined medial meniscal allograft transplantation and anterior cruciate ligament reconstruction: minimum 8.5-yr follow-up study. Arthroscopy 2004;20:129–140.

    Article  PubMed  Google Scholar 

  34. vanArkel ERA, deBoer HH. Human meniscal transplantation. Preliminary results at 2-to 5-yr follow-up. J Bone Joint Surg Br 1995;77-B:589–595.

    Google Scholar 

  35. deBoer HH, Koudstaal J. Failed meniscus transplantation. A report of three cases. Clin Orthop Relat Res 1994;306:155–162.

    PubMed  Google Scholar 

  36. Bauer GC, Insall J, Koshino T. Tibial osteotomy in gonarthrosis (osteo-arthritis of the knee). J Bone Joint Surg Am 1969;51:1545–1563.

    PubMed  CAS  Google Scholar 

  37. Kettelkamp DB, Leach RE, Nasca R. Pitfalls of proximal tibial osteotomy. Clin Orthop Relat Res 1975; 106:232–241.

    Article  PubMed  Google Scholar 

  38. Waugh W. Tibial osteotomy in the management of osteoarthritis of the knee. Clin Orthop Relat Res 1986;210:55–61.

    PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  40. Hofmann AA, Wyatt RW, Beck SW. High tibial osteotomy. Use of an osteotomy jig, rigid fixation, and early motion vs conventional surgical technique and cast immobilization. Clin Orthop RelatRes 1991;271:212–217.

    Google Scholar 

  41. Billings A, Scott DF, Camargo MP, Hofmann AA. High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion. Long-term follow-up. J Bone Joint Surg Am 2000;82:70–79.

    PubMed  CAS  Google Scholar 

  42. Insall JN, Joseph DM, Msika C. High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 1984;66:1040–1048.

    PubMed  CAS  Google Scholar 

  43. Sprenger TR, Doerzbacher JF. Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to 22 yr. J Bone Joint Surg Am 2003;85-A:469–474.

    PubMed  Google Scholar 

  44. Matthews LS, Goldstein SA, Malvitz TA, Katz BP, Kaufer H. Proximal tibial osteotomy. Factors that influence the duration of satisfactory function. Clin Orthop 1988:193–200.

    Google Scholar 

  45. Amendola A. Unicompartmental osteoarthritis in the active patient: the role of high tibial osteotomy. Arthroscopy 2003;19(suppl 1):109–116.

    Article  PubMed  Google Scholar 

  46. Amendola A, Fowler PJ, Litchfield R, Kirkley S, Clatworthy M. Opening wedge high tibial osteotomy using anovel technique: early results and complications. J Knee Surg 2004;17:164–169.

    PubMed  CAS  Google Scholar 

  47. Sterett WI, Steadman JR. Chondral resurfacing and high tibial osteotomy in the varus knee. Am J Sports Med 2004;32:1243–1249.

    Article  PubMed  Google Scholar 

  48. Catagni MA, Guerreschi F, Ahmad TS, Cattaneo R. Treatment of genu varum in medial compartment osteoarthritis of the knee using the Ilizarov method. Orthop Clin North Am 1994;25:509–514.

    PubMed  CAS  Google Scholar 

  49. Magyar G, Ahl TL, Vibe P, Toksvig-Larsen S, Lindstrand A. Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations. J Bone Joint Surg Br 1999;81:444–448.

    Article  PubMed  CAS  Google Scholar 

  50. Coventry MB. Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee. J Bone Joint Surg Am 1987;69:32–38.

    PubMed  CAS  Google Scholar 

  51. Keene JS, Dyreby JR, Jr. High tibial osteotomy in the treatment of osteoarthritis of the knee. The role of preoperative arthroscopy. J Bone Joint Surg Am 1983;65:36–42.

    PubMed  CAS  Google Scholar 

  52. Miniaci A, Ballmer FT, Ballmer PM, Jakob RP. Proximal tibial osteotomy. A new fixation device. Clin Orthop Relat Res 1989;246:250–259.

    PubMed  Google Scholar 

  53. Aglietti P, Rinonapoli E, Stringa G, Taviani A. Tibial osteotomy for the varus osteoarthritic knee. Clin Orthop Relat Res 1983; 176:239–251.

    PubMed  Google Scholar 

  54. Yasuda K, Majima T, Tsuchida T, Kaneda K. A 10-to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res 1992;282:186–195.

    PubMed  Google Scholar 

  55. Coventry MB, Ilstrup DM, Wallrichs SL. Proximal tibial osteotomy. A critical long-term study of 87 cases. J Bone Joint Surg Am 1993;75:196–201.

    PubMed  CAS  Google Scholar 

  56. Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. Survivorship of the high tibial osteotomy: A 10-to 22-yr followup study. Clin Orthop 1999;367:18–27.

    PubMed  Google Scholar 

  57. Vainionpaa S, Laike E, Kirves P, Tiusanen P. Tibial osteotomy for osteoarthritis of the knee. A 5-to 10-yr follow-up study. J Bone Joint Surg Am 1981;63:938–946.

    PubMed  CAS  Google Scholar 

  58. Koshino T, Morii T, Wada J, et al. High tibial osteotomy with fixation by a blade plate for medial compartment osteoarthritis of the knee. Orthop Clin North Am 1989;20:227–243.

    PubMed  CAS  Google Scholar 

  59. Kanamiya T, Naito M, Hara M, Yoshimura I. The influences of biomechanical factors on cartilage regeneration after high tibial osteotomy for knees with medial compartment osteoarthritis: clinical and arthroscopic observations. Arthroscopy 2002; 18:725–729.

    Article  PubMed  Google Scholar 

  60. Ivarsson I, Myrnerts R, Gillquist J. High tibial osteotomy for medial osteoarthritis of the knee. A 5-to 7-and 11-yr follow-up. J Bone Joint Surg Br 1990;72:238–244.

    PubMed  CAS  Google Scholar 

  61. Rudan JF, Simurda MA. High tibial osteotomy. A prospective clinical and roentgenographic review. Clin Orthop Relat Res 1990;255:251–256.

    PubMed  Google Scholar 

  62. Hernigou P, Medevielle D, Debeyre J, Goutallier D. Proximal tibial osteotomy for osteoarthritis with varus deformity. A 10-to 13-yr follow-up study. J Bone Joint Surg Am 1987;69:332–354.

    PubMed  CAS  Google Scholar 

  63. Insall J, Shoji H, Mayer V. High tibial osteotomy. A 5-yr evaluation. J Bone Joint Surg Am 1974;56:1397–1405.

    PubMed  CAS  Google Scholar 

  64. Stuart MJ, Grace JN, Ilstrup DM, et al. Late recurrence of varus deformity after proximal tibial osteotomy. Clin Orthop Relat Res 1990;260:61–65.

    PubMed  Google Scholar 

  65. Shaw JA, Dungy DS, Arsht SS. Recurrent varus angulation after high tibial osteotomy: an anatomic analysis. Clin Orthop Relat Res 2004;420:205–212.

    Article  PubMed  Google Scholar 

  66. Morrey BF. Upper tibial osteotomy for secondary osteoarthritis of the knee. J Bone Joint Surg Br 1989;71:554–559.

    PubMed  CAS  Google Scholar 

  67. Shoji H, Insall J. High tibial osteotomy for osteoarthritis of the knee with valgus deformity. J Bone Joint Surg Am 1973;55:963–973.

    PubMed  CAS  Google Scholar 

  68. Williams R Jr, Kelly BT, Wickiewicz TL, Altchek DW, Warren RW. The short-term outcome of surgical treatment for painful varus arthritis in association with chronic ACL deficiency. J Knee Surg 2003; 16:9–16.

    PubMed  Google Scholar 

  69. Holden DL, James SL, Larson RL, Slocum DB. Proximal tibial osteotomy in patients who are 50 yr old or less. A long-term follow-up study. J Bone Joint Surg Am 1988;70:977–982.

    PubMed  CAS  Google Scholar 

  70. Kaper BP, Bourne RB, Rorabeck CH, Macdonald SJ. Patellar infera after high tibial osteotomy. J Arthroplasty 2001;16:168–173.

    Article  PubMed  CAS  Google Scholar 

  71. Scuderi GR, Windsor RE, Insall JN. Observations on patellar height after proximal tibial osteotomy. J Bone Joint Surg Am 1989;71:245–248.

    PubMed  CAS  Google Scholar 

  72. Prodromos CC, Andriacchi TP, Galante JO. A relationship between gait and clinical changes following high tibial osteotomy. J Bone Joint Surg Am 1985;67:1188–1194.

    PubMed  CAS  Google Scholar 

  73. Wang JW, Kuo KN, Andriacchi TP, Galante JO. The influence of walking mechanics and time on the results of proximal tibial osteotomy. J Bone Joint Surg Am 1990;72:905–909.

    PubMed  CAS  Google Scholar 

  74. Nagel A, Insall JN, Scuderi GR. Proximal tibial osteotomy. A subjective outcome study. J Bone Joint Surg Am 1996;78:1353–1358.

    PubMed  CAS  Google Scholar 

  75. Dugdale TW, Noyes FR, Styer D. Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 1992;274:248–264.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Sports Medicine and Shoulder Surgery, Orthopedic Institute, Sioux Falls, SD

    Keith M. Baumgarten MD

  2. Weill Medical College of Cornell University, New York, NY

    Thomas L. Wickiewicz MD (Professor of Clinical Orthopaedic Surgery, Attending Orthopaedic Surgeon)

  3. Hospital for Special Surgery, New York, NY

    Thomas L. Wickiewicz MD (Professor of Clinical Orthopaedic Surgery, Attending Orthopaedic Surgeon)

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  1. Keith M. Baumgarten MD
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  2. Thomas L. Wickiewicz MD
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Editors and Affiliations

  1. Weill Medical College of Cornell University, USA

    Riley J. Williams III MD (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director) (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director)

  2. Institute for Cartilage Repair, Hospital for Special Surgery, New York, NY

    Riley J. Williams III MD (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director) (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director)

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© 2007 Humana Press Inc., Totowa, NJ

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Baumgarten, K.M., Wickiewicz, T.L. (2007). The Role of Knee Osteotomy in the Setting of Articular Cartilage Repair. In: Williams, R.J. (eds) Cartilage Repair Strategies. Humana Press. https://doi.org/10.1007/978-1-59745-343-1_15

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  • DOI: https://doi.org/10.1007/978-1-59745-343-1_15

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-629-0

  • Online ISBN: 978-1-59745-343-1

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