Abstract
Introduction
Osteotomy around the knee is well established in orthopaedic surgery in cases of congenital/posttraumatic leg deformities with mono-compartment osteoarthritis of the knee. However, there is no consensus whether there should be an arthroscopy prior to osteotomy in the same operative session, either for diagnostic or therapeutic reasons.
Patients and methods
This prospective study included 340 cases of osteotomy around the knee with a routine arthroscopy. During arthroscopy indication for osteotomy was checked first. Then cartilage status was determined to modify type and degree of correction osteotomy accordingly. Finally therapeutic procedures were performed in cases of intraarticular pathologies.
Results
Indication was rejected in 47 cases with ten patients receiving endoprosthetic treatment. In 157 cases the degree of correction was modified, in eleven cases the level of osteotomy. Under the 330 non-endoprothetic sessions there were 316 arthroscopies with therapeutic treatments.
Conclusion
This study could demonstrate that arthroscopy in the same session is indispensable, to check the indication for osteotomy, to modify type and degree of correction according to cartilage status and to perform therapeutic procedures.
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References
Friemert B, Oberländer Y, Danz B, Häberle HJ, Bähren W, Gerngroß H, Schwarz W (2002) MRI versus arthroscopy in the diagnosis of cartilage lesions of the knee. Can MRI take place of arthroscopy? Zentralbl Chir 127:822–827
Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am [USA] 10(3):585–608
Haeri GB, Orth M, Wiley AM (1980) High tibial osteotomy combined with joint débridement. A long-term study of results. Clin Orth Rel Res 51:153–159
Irie K, Yamada T, Inoue K (2000) A comparison of magnetic resonance imaging and arthroscopic evaluation of chondral lesions of the knee. Orthopedics 23:561–564
Jackson JP (1958) Osteotomy for osteoarthritis of the knee. J Bone Joint Surg [Br] 40–B:826
Joneleit M, Köng U, Friederich NF (2004) Arthroscopy prior to osteotomy? Arthroskopie 17:239–241
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthrosis. Ann Rheum Dis 16:494–502
Langenbeck B (1854) Die subcutane Osteotomie. Dtsch Klinik 6:327–330
Marti CB, Gautier E, Wachtl SW, Jakob RP (2004) Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy 20(4):366–372
Ogata K, Yoshii I, Kawamura H, Miura H, Arizono T, Sugioka Y (1991) Standing radiographs cannot determine the correction in high tibial osteotomy. J Bone Joint Surg [Br] 73–B:927–931
Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg [Br] 43–B:7522–7527
Paley D (2002) Principles of deformity correction. Springer, Berlin
Rozkydal Z, Kura V, Ondrusek S (2003) The arthroscopic debridement in the management of osteoarthritis of the knee joint by high tibial osteotomy. Bratisl Lek Listy 104(11):362–366
Schultz W, Urbach B (2000) Osteotomy close to the knee for degenerative arthritis. Zentralbl Chir 25:523–531
Strecker W (2006) Planning analysis of knee-adjacent deformities. Oper Orthop Traumatol 3:259–272
Vojtassak J, Seliga J (2001) High tibial osteotomy and debridement of the knee joint in treatment of varotic gonarthrosis. Bratisl Lek Listy 102(10):470–472
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Müller, M., Strecker, W. Arthroscopy prior to osteotomy around the knee?. Arch Orthop Trauma Surg 128, 1217–1221 (2008). https://doi.org/10.1007/s00402-007-0398-4
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DOI: https://doi.org/10.1007/s00402-007-0398-4