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High tibial osteotomy

Troy A Roberson, Amit M Momaya, Kyle Adams, Catherine D Long, John M Tokish, Douglas J Wyland
Background: High tibial osteotomy (HTO) is a valuable treatment option in the high-demand patient with chondral damage and an altered mechanical axis. Traditional opening wedge HTO performed with metal plates has several limitations, including hardware irritation, obscuration of detail on magnetic resonance imaging, and complexity of revision surgery. Recently, an all-polyetheretherketone (PEEK) HTO implant was introduced, but no studies to date have evaluated the performance of this implant with minimum 2-year outcomes compared with a traditional metal plate...
March 2018: Orthopaedic Journal of Sports Medicine
R Siboni, P Beaufils, P Boisrenoult, C Steltzlen, N Pujol
INTRODUCTION: Using locking plates in opening-wedge high tibial osteotomy (OWHTO) via a medial opening theoretically allows early weight-bearing without need for bone or bone-substitute grafting. It incurs a risk of non-consolidation in case of large correction (> 10°), although rates and risk factors of non-union are not known. The present retrospective study compared OWHTO with correction <10° versus >10°, with a view to determining: 1) complications rates (non-union) according to degree of correction, and 2) risk factors for such complications...
March 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Zhi-Peng Wu, Pei Zhang, Jian-Zhong Bai, Yuan Liang, Peng-Tao Chen, Jin-Shan He, Jing-Cheng Wang
BACKGROUND: High tibial osteotomy (HTO) is a usefully surgical procedure to correct the malalignment and delay the progression of osteoarthritis. It is still controversy whether navigation system can offer more accuracy of targeted alignment and achieve better clinical outcomes than conventional method. The purpose of present meta-analysis was to investigate whether navigation system was superior to conventional method with regard to clinical and radiographic outcomes. METHOD: The included studies compared the clinical and radiographic outcomes between navigated HTO group and conventional group...
March 16, 2018: International Journal of Surgery
Chao Xiong, Zhiquan Zhang, Gurpreet S Baht, Niccolo Terrando
Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and significantly diminish the outcome. Indeed, after routine orthopedic surgery to repair a fracture, as many as 50% of elderly patients suffer from neurologic complications like delirium. Also, the capacity to heal and regenerate tissue after surgery decreases with age, and can impact the quality of fracture repair and even osseous integration of implants. Thus, a better understanding of mechanisms that drive these age-dependent changes could provide strategic targets to minimize risk for such complications and optimize outcomes...
February 27, 2018: Journal of Visualized Experiments: JoVE
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
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
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
Zhi-Dong Zhao, Peng-Cui Li, Xiao-Chun Wei
Up to now, surgical treatment of recurrent lateral patellar dislocation mainly includes: medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, trochleoplasty, lateral retinacular release, derotation osteotomy and so on . Clinical reports show that: the use of a single or combined with several methods have achieved ideal short to mid-term clinical outcomes. However, there is no consolidate criterion concerning the choices of different kinds of surgical ways for the treatment of individual recurrent lateral patellar dislocation...
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
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
Davide Edoardo Bonasia, Federico Dettoni, Anna Palazzolo, Roberto Rossi
High tibial osteotomy (HTO) is a valid treatment option for young active patients with medial tibiofemoral osteoarthrosis (OA) and varus deformity. Sometimes medial OA is combined with symptomatic anterior cruciate ligament (ACL) deficiency. Although isolated HTO (with possible delayed ACL reconstruction) might be indicated in the older population, young active patients may require combined HTO and ACL reconstruction. In addition, an abnormally increased tibial slope may predispose to ACL reconstruction failure and should be addressed for a successful ACL revision...
October 2017: Arthroscopy Techniques
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
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)
Wenjun Xie, Yu Zhang, Xiaodong Qin, Lijun Song, Qun Chen
High fibular osteotomy has been preliminarily proved to be an effective treatment of knee osteoarthritis by excising a segment of bone at the proximal part of fibula. This imaginative procedure is clinical validated by its instant and explicit knee pain resorption and eventually deformity correction. The rationale of this treatment is named non-uniform settlement of the tibial plateau and used to elucidate the cause of knee joint degeneration, but cannot illuminate the reason of prompt postoperative pain resorption faithfully...
March 2018: Journal of Orthopaedics
Noah B Bander, Matthew D Barnhart, Adam T Watson, Steven J Naber
This study investigated the short-term radiographic healing of the osteotomy following tibial tuberosity advancement (TTA), maintenance of patellar tendon angle (PTA), and complications in dogs receiving a polyglycolic acid (PGA) TTA cage. Patients diagnosed with unilateral cranial cruciate ligament disease requiring a 9- or 12-mm TTA cage were included. Twenty-six consecutive client-owned dogs were prospectively selected for this clinical study. Age, weight, sex, breed, cage size, surgery date, and follow-up time were recorded...
January 26, 2018: Journal of the American Animal Hospital Association
Taehun Kim, Haksun Chung, Hyungmin Lee, Young Choi, Jung-Hwan Son
RATIONALE: The fabella is a normal structure, but is occasionally reported to cause posterior knee pain. The aim of this study was to present fabella syndrome after high tibial osteotomy. PATIENT CONCERNS: A 55-year-old female patient was admitted to the hospital due to about 1 year and 8 months of left knee pain. Sclerosis was observed in the anterior margin of the fabella in the preoperative magnetic resonance (MR) T2 image, and reactive bone marrow was found and was considered to be due to degeneration of the distal femur...
January 2018: Medicine (Baltimore)
Domenico Albano, Nicolò Martinelli, Alberto Bianchi, Giovanni Romeo, Gaetano Bulfamante, Massimo Galia, Luca Maria Sconfienza
OBJECTIVE: To investigate the correlation between MRI, clinical tests, histopathologic features of posterior tibial tendon (PTT) dysfunction in patients with acquired adult flatfoot deformity surgically treated with medializing calcaneal osteotomy and flexor digitorum longus tendon transposition. MATERIALS AND METHODS: Nineteen patients (11 females; age: 46 ± 15 year, range 18-75) were pre-operatively evaluated using the single heel rise (HR) and the first metatarsal rise (FMR) sign tests...
February 2018: European Journal of Radiology
R Torres-Claramunt, X Pelfort, P Hinarejos, S Gil-González, J Leal, J F Sánchez-Soler, J C Monllau
PURPOSE: The aim of this study was to assess the utility of pressure algometry (PA) to measure pain relief in the medial part of the knee after a closing-wedge high tibial osteotomy (CWHTO). METHODS: Prospective study including 44 CWHTO. Pain relief was evaluated with the visual analogue scale (VAS) and PA, a radiological study was done and a functional assessment was carried out with the KSS pre-operatively, at 6-months and at 1-year after the surgery. PA was applied to the medial and lateral part of the knee and to the infra-clavicular fossa as a control point...
January 18, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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