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Knee osteotomy

Young Woong Jang, DoHyung Lim, Hansol Seo, Myung Chul Lee, O-Sung Lee, Yong Seuk Lee
INTRODUCTION: Open-wedge high tibial osteotomy (OWHTO) is a well-established surgical option for medial compartment osteoarthritis of the varus knee. The initial strength of the fixation plate is critical for successful correction maintenance and healing of the osteotomy site. This study was conducted to verify if a newly designed anatomical plate (LCfit) improves the stability of both the medial implant and lateral hinge area, as well as to evaluate how the metal block contributes to both medial and lateral stability...
March 15, 2018: Archives of Orthopaedic and Trauma Surgery
Firooz Salami, Julia Wagner, Stefan van Drongelen, Matthias C M Klotz, Thomas Dreher, Sebastian I Wolf, Mirjam Niklasch
AIM: Flexed knee gait can be treated with distal femoral extension osteotomy (DFEO) and additional patellar tendon advancement (PTA) in children with cerebral palsy (CP). This study assesses changes in hamstring muscle tendon length (MTL) and velocity after DFEO (+PTA). METHOD: Nineteen children (mean age 13y [standard deviation 3y] at surgery) with CP and flexed knee gait who were treated with DFEO (15 limbs) or DFEO+PTA (10 limbs) were retrospectively included in this study...
March 14, 2018: Developmental Medicine and Child Neurology
Melvin C Makhni, Jamal N Shillingford, Joseph L Laratta, Seung-Jae Hyun, Yongjung J Kim
The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration...
March 2018: Journal of Korean Neurosurgical Society
Hiroshi Inui, Shuji Taketomi, Ryota Yamagami, Nobuyuki Shirakawa, Kouhei Kawaguchi, Sakae Tanaka
A new design of the so-called "guided-motion" total knee arthroplasty (TKA) is expected to produce normal-like kinematics. The implant behaves strictly as a mechanically constraint-guided motion system. However, no previous reports have demonstrated the most appropriate surgical technique or soft-tissue balance that would reproduce ideal kinematics. The purpose of this study was to clarify the relationship between soft-tissue balance and the intraoperative kinematics of guided-motion TKA. In this study, intraoperative kinematics of 95 patients whose TKA was performed with a guided-motion prosthesis (Journey II BCS Smith and Nephew) were measured using the computed tomography (CT)-free navigation system...
March 7, 2018: Journal of Knee Surgery
Da-Hui Sun, Yi Zhao, Ji-Ting Zhang, Dong Zhu, Bao-Chang Qi
RATIONALE: It is challenging to visualize and reduce a posterolateral tibial plateau fracture through an anterolateral approach as the tibial plateau fragments are often covered by the fibular head and ligamentous structures. PATIENT CONCERNS: In this case report, we describe a patient with a depression fracture of the posterolateral quadrant combined with a split fracture of the posteromedial quadrant and an avulsion fracture of the tibial intercondylar eminence...
January 2018: Medicine (Baltimore)
Kyle John Hancock, Robert R Westermann, Alan Gregory Shamrock, Kyle R Duchman, Brian R Wolf, Annunziato Amendola
This study aims to evaluate the trends in treatment of knee articular cartilage lesions over the past decade using data obtained from the American Board of Orthopaedic Surgery (ABOS) Part II database. The ABOS Part II database was queried from 2004 to 2013 for chondroplasty, microfracture, and osteochondral grafting procedures. All cases were analyzed for patient age and operating surgeon's fellowship training status. Univariate analysis including chi-square test for categorical variables and Student's t -test for continuous variables was performed to determine if any significant changes in practice patterns were present...
February 28, 2018: Journal of Knee Surgery
Hyun Il Lee, Dongjun Park, Jinho Cho
Purpose: To identify the structural integrity of the healing site after medial open wedge high tibial osteotomy (MOWHTO) in patients with a posterior root tear of the medial meniscus (PRTMM) and chondral lesion by second-look arthroscopy and to determine the clinical and radiological findings. Materials and Methods: From August 2010 to June 2016, 52 consecutive patients underwent MOWHTO and arthroscopic examination without a chondral resurfacing procedure and meniscal treatment for PRTMM...
March 1, 2018: Knee Surgery & related Research
M Janoyer
Blount disease is an asymmetrical disorder of proximal tibial growth that produces a three-dimensional deformity. Tibia vara is the main component of the deformity. Blount disease exists as two clinical variants, infantile or early-onset, and adolescent or late-onset, defined based on whether the first manifestations develop before or after 10 years of age. The pathophysiological mechanisms are unclear. In the Americas and Caribbean, Blount disease chiefly affects black obese children. Without treatment, the prognosis is often severe, particularly in the infantile form due to the development of medial tibial epiphysiodesis at about 6 to 8 years of age...
February 23, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Xavier Paredes-Carnero, Manuel Leyes, Francisco Forriol, Ana Belén Fernández-Cortiñas, Jesús Escobar, Javier G Babé
PURPOSE: Sometimes, total knee replacement (TKR) is performed after a tibial osteotomy. It is not known if the osteotomy influences the clinical process of a TKR. The aim of this study was to look at the clinical outcome of a TKR after high tibial osteotomy (HTO) compared to a TKR with no HTO. METHODS: Between 1995 and 2005, 41 post-HTO TKRs (group A) with a minimum follow-up of ten years were selected. In parallel, it was selected a control group undergoing simple TKR, consisting of 41 patients (group B) matched with group A...
February 20, 2018: International Orthopaedics
Li-Chuang Wu, Hai-Bo Zhou, Chao Zhang, Lei Chen, Cai-Long Liu
OBJECTIVE: To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinaculum, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella. METHODS: From March 2010 to May 2016, 35 patients with habitual patellar dislocation were treated with the triad operation, including 14 males, 21 females, ranging in age from 18 to 38 years old, with an average of 25...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Kun-Ming Ren, Pei-Liang Zhang
OBJECTIVE: To evaluate the short-and mid-term curative effect of high fibular osteotomy on knee osteoarthritis. METHODS: From October 2014 to July 2016, 76 patients with knee osteoarthritis were treated with high fibular osteotomy. There were 22 males and 54 females, ranging in age from 47 to 82 years old, with an average of 61.62 years old. Internal tenderness of the knee joint was examined preoperatively. Preoperative examination showed medial knee pain and medial positive McMurray sign...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Shi-Hui Xiao, Ding-Wei Liu, Fu-Cheng Yang, Xiang-Min Zhang
OBJECTIVE: To evaluate the clinical efficacy of open supracondylar osteotomy of the femoral condyle for the treatment of valgus knee osteoarthritis. METHODS: From April 2008 to June 2015, 21 patients with valgus knee osteoarthritis underwent an open wedge femoral supracondylar osteotomy using the distal femur dissection plates combined with autologous iliac bone graft for the bone defect. There were 8 males (8 knees) and 13 females (15 knees), ranging in age from 30 to 54 years old, with a mean age of 41...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
G Filardo, S Zaffagnini, R De Filippis, F Perdisa, L Andriolo, C Candrian
PURPOSE: To assess whether the combination of HTO and cartilage treatment produced an additional clinical benefit compared to HTO alone. The secondary aim was to identify if there was any difference among different cartilage procedures in terms of healing potential and clinical outcome. METHODS: A systematic review of the literature was performed on PubMed database by three independent observers according to the following inclusion criteria: clinical reports of any level of evidence, written in the English language, with no time limitation, about HTO associated with cartilage surgical and injective treatment, including surveys reporting clinical, radiological, or second-look outcomes at any follow-up time...
February 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
E Carlos Rodriguez-Merchan
High tibial osteotomy (HTO) is a well established technique for the treatment of medial osteoarthritis of the knee with varus malalignment. The outcome of total knee arthroplasty (TKA) after HTO remains uncertain. The aim of this paper is to revise the literature with the aim of answering the following question: Does a previous (HTO) influence the long-term function or survival of a TKA?. The search engine was MedLine. The keywords used were: total knee arthroplasty after high tibial osteotomy. One hundred and ten articles were found...
January 2018: Archives of Bone and Joint Surgery
Jonathan A Godin, Zaamin B Hussain, Anthony Sanchez, George Sanchez, Márcio B Ferrari, Mark E Cinque, Nicholas I Kennedy, Matthew T Provencher
Chondral lesions of the knee can occur secondary to limb malalignment. To address these interrelated problems, a high tibial osteotomy with concomitant osteochondral allograft transfer may be performed. It is important to address these chondral lesions as they often affect the young and active population and cause morbidity in an otherwise healthy population. Although numerous approaches for the treatment of chondral lesions have been described, long-term results demonstrating regeneration of hyaline cartilage have yet to be reported...
October 2017: Arthroscopy Techniques
Miho J Tanaka
Medial patellofemoral ligament reconstruction is commonly performed to treat patellofemoral instability by recreating the static soft tissue restraint to lateral patellar translation. Concurrent tibial tuberosity osteotomy can be indicated in the setting of bony malalignment, such as a lateralized tuberosity or patella alta; however, the exact indications for this have been difficult to define due to the multifactorial nature of this problem. Understanding the role of tuberosity lateralization and patella alta on the function of medial patellofemoral ligament grafts can help to identify the interplay of some factors that contribute to patellar stability and improve our understanding of when and how concurrent tibial tuberosity osteotomy may be indicated...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jennifer Lb Martay, Antony Jr Palmer, Neil K Bangerter, Stuart Clare, A Paul Monk, Cameron P Brown, Andrew J Price
BACKGROUND: High tibial osteotomy (HTO) re-aligns the weight-bearing axis (WBA) of the lower limb. The surgery reduces medial load (reducing pain and slowing progression of cartilage damage) while avoiding overloading the lateral compartment. The optimal correction has not been established. This study investigated how different WBA re-alignments affected load distribution in the knee, to consider the optimal post-surgery re-alignment. METHODS: We collected motion analysis and seven Tesla MRI data from three healthy subjects, and combined this data to create sets of subject-specific finite element models (total=45 models)...
January 21, 2018: Knee
Tim Wang, Nicole S Belkin, Alissa J Burge, Brenda Chang, Mollyann Pais, Gregory Mahony, Riley J Williams
PURPOSE: To analyze the functional outcomes of patients treated with particulated juvenile articular cartilage (PJAC) for symptomatic articular cartilage lesions in the patellofemoral joint, correlates clinical outcomes with magnetic resonance imaging (MRI) appearance of the repair tissue using cartilage-sensitive quantitative T2-mapping. METHODS: All patients treated with PJAC for patellofemoral lesions were identified and prospectively followed with clinical outcome scores (International Knee Documentation Committee [IKDC], Knee Outcome Survey-Activities of Daily Living [KOS-ADL], and Marx Activity Scale [MAS])...
January 29, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Rene Burchard, Denise Katerla, Marina Hammer, Anke Pahlkötter, Christian Soost, Gerhard Dietrich, Arne Ohrndorf, Wolfgang Richter, Markus Lengsfeld, Hans-Jürgen Christ, Jan Adriaan Graw, Claus-Peter Fritzen
PURPOSE: Opening wedge high tibial osteotomy (HTO) as a treatment in unicompartimental osteoarthritis of the knee can significantly relieve pain and prevent or at least delay an early joint replacement. The fixation of the osteotomy has undergone development and refinements during the last years. The angle-stable plate fixator is currently one of the most commonly used plates in HTOs. The angular stable fixation between screws and the plate offers a high primary stability to retain the correction with early weight-bearing protocols...
February 1, 2018: International Orthopaedics
Seung-Beom Han, Hee-Soo Kyung, In-Wook Seo, Young-Soo Shin
BACKGROUND: Both high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are well-established treatments for medial knee osteoarthritis (OA). However, it is unclear whether HTO or UKA leads to better clinical outcomes and lower complication rates. This meta-analysis compared the clinical outcomes and complications of HTO and UKA in patients with medial knee OA. METHODS: All studies comparing the functional outcome, postoperative pain, revision rate to total knee arthroplasty (TKA), postoperative complications, postoperative velocity, and postoperative range of motion (ROM) as assessed with various measurement tools in patients with medial knee OA treated with HTO or UKA were included...
December 2017: Medicine (Baltimore)
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