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Unicompartmental osteoarthritis in the active patient: the role of high tibial osteotomy

      Proximal tibial osteotomies are an important component of the surgical treatment options in the management of knee osteoarthritis. The value of osteotomy is in the knee with localized osteoarthritis and a corresponding malalignment that is either causative or contributory to the arthritis. The principle of correcting malalignment to transfer load to the relatively unaffected compartment of the knee, to relieve symptoms and slow disease progression, is a concept that has been used for many years,
      • Coventry M.B.
      Upper tibial osteotomy.
      with techniques becoming more refined with time. In addition, despite good long-term results with total knee arthroplasty, there remains a significant concern regarding the longevity of these prostheses, particularly in younger patients. In contrast, osteotomy provides an alternative that preserves the knee joint, which, when appropriately performed, should not compromise later arthroplasty should this be necessary.
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      References

        • Coventry M.B.
        Upper tibial osteotomy.
        Clin Orthop. 1984; : 46-52
        • Billings A.
        • Scott D.F.
        • Camargo M.P.
        • Hofmann A.A.
        High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion.
        J Bone Joint Surg Am. 2000; 82: 70-79
        • Coventry M.B.
        • Ilstrup D.M.
        • Wallrichs S.L.
        Proximal tibial osteotomy.
        J Bone Joint Surg Am. 1993; 75: 196-201
        • Insall J.N.
        • Joseph D.M.
        • Msika C.
        High tibial osteotomy for varus gonarthrosis.
        J Bone Joint Surg Am. 1984; 66: 1040-1048
        • Ivarsson I.
        • Myrnerts R.
        • Gillquist J.
        High tibial osteotomy for medial osteoarthritis of the knee.
        J Bone Joint Surg Br. 1990; 72: 238-244
        • Naudie D.
        • Bourne R.B.
        • Rorabeck C.H.
        • Bourne T.J.
        The Install Award: Survivorship of the high tibial valgus osteotomy: A 10- to 22-year followup study.
        Clin Orthop. 1999; : 18-27
        • Rinonapoli E.
        • Mancini G.B.
        • Corvaglia A.
        • Musiello S.
        Tibial osteotomy for varus gonarthrosis.
        Clin Orthop. 1998; : 185-193
        • Yasuda K.
        • Majima T.
        • Tsuchida T.
        • Kaneda K.
        A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis.
        Clin Orthop. 1992; : 186-195
        • Dugdale T.W.
        • Noyes F.R.
        • Styer D.
        Preoperative planning for high tibial osteotomy.
        Clin Orthop. 1992; : 248-264
        • Ogata K.
        • Yoshii I.
        • Kawamura H.
        • et al.
        Standing radiographs cannot determine the correction in high tibial osteotomy.
        J Bone Joint Surg Br. 1991; 73: 927-931
        • Coventry M.B.
        Upper tibial osteotomy for osteoarthritis.
        J Bone Joint Surg Am. 1985; 67: 1136-1140
        • Miniaci A.
        • Ballmer F.T.
        • Ballmer P.M.
        • Jakob R.P.
        Proximal tibial osteotomy.
        Clin Orthop. 1989; : 250-259
        • Insall J.
        • Shoji H.
        • Mayer V.
        High tibial osteotomy.
        J Bone Joint Surg Am. 1974; 56: 1397-1405
        • Georgoulis A.D.
        • Makris C.A.
        • Papageorgiou C.D.
        • et al.
        Nerve and vessel injuries during high tibial osteotomy combined with distal fibular osteotomy.
        Knee Surg Sports Traumatol Arthrosc. 1999; 7: 15-19
        • Hernigou P.
        • Medevielle D.
        • Debeyre J.
        • Goutallier D.
        Proximal tibial osteotomy for osteoarthritis with varus deformity.
        J Bone Joint Surg Am. 1987; 69: 332-354
        • Magyar G.
        • Ahl T.L.
        • Vibe P.
        • et al.
        Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee.
        J Bone Joint Surg Br. 1999; 81: 444-448
        • Amendola A.
        • Mrkonjic L.
        • Clatworthy M.
        • Kirkley A.
        Opening wedge high tibial osteotomy using a Puddu distraction plate. 1999 (Presented at the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, Washington, DC)
        • Amendola A.
        • Giffin R.
        • Sanders D.
        • et al.
        Osteotomy for knee instability. 2001 (Presented at Specialty Day of American Orthopaedic Society for Sports Medicine, San Francisco, March)
        • Maquet P.
        Valgus osteotomy for osteoarthritis of the knee.
        Clin Orthop. 1976; 00: 143-148
        • Takahashi T.
        • Wada Y.
        • Tanaka M.
        • et al.
        Dome-shaped proximal tibial osteotomy using percutaneous drilling for osteoarthritis of the knee.
        Arch Orthop Trauma Surg. 2000; 120: 32-37
        • Sundaram N.A.
        • Hallett J.P.
        • Sullivan M.F.
        Dome osteotomy of the tibia for osteoarthritis of the knee.
        J Bone Joint Surg Br. 1986; 68: 782-786
        • Catagni M.A.
        • Guerreschi F.
        • Ahmad T.S.
        • 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
        • Klinger H.M.
        • Lorenz F.
        • Harer T.
        Open wedge tibial osteotomy by hemicallotasis for medial compartment osteoarthritis.
        Arch Orthop Trauma Surg. 2001; 121: 245-247
        • Weale A.E.
        • Lee A.S.
        • MacEachern A.G.
        High tibial osteotomy using a dynamic axial external fixator.
        Clin Orthop. 2001; : 154-167
        • Geiger F.
        • Schneider U.
        • Lukoschek M.
        • Ewerbeck V.
        External fixation in proximal tibial osteotomy.
        Int Orthop. 1999; 23: 160-163

      Further reading

        • Smith P.N.
        • Gelinas J.
        • Kennedy K.
        • et al.
        Popliteal vessels in knee surgery.
        Clin Orthop. 1999; : 158-164
        • Hofmann A.A.
        • Wyatt R.W.
        • Beck S.W.
        High tibial osteotomy.
        Clin Orthop. 1991; 271: 212-217
        • Coventry M.B.
        Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee.
        J Bone Joint Surg Am. 1987; 69: 32-38
        • Shoji H.
        • Insall J.
        High tibial osteotomy for osteoarthritis of the knee with valgus deformity.
        J Bone Joint Surg Am. 1973; 55: 963-973
        • Chambat P.
        • Ait Si Selmi T.
        • Dejour D.
        • Denoyers J.
        Varus Tibial osteotomy.
        Oper Tech Sports Med. 2000; 8: 44-47
        • Marti R.K.
        • Verhagen R.A.
        • Kerkhoffs G.M.
        • Moojen T.M.
        Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one-year results.
        J Bone Joint Surg Am. 2001; 83: 164-170