Osteotomy

Osteotomy

Varus or valgus alignment or deformity of the knee can abnormally load the medial or lateral compartment, resulting in premature degenerative change in that compartment. Osteotomy aims to divide the bone, correct the deformity and alter the load-bearing mechanics of the joint. The most commonly performed operation is a high tibial osteotomy (HTO) for a varus knee. Realignment is achieved with either an opening-wedge medial HTO or a closing-wedge lateral HTO. The amount of angular correction is calculated preoperatively and then created in theatre with jigs under radiographic control. Fixation with modern plates and locking screws allows early weight-bearing and mobilisation. The ideal patient for osteotomy is a young, active and well-motivated individual with disease limited to one compartment.

(b) Figure 40.4 Anteroposterior (a) and lateral (b) radiographs of a uni compartmental knee replacement.

Osteotomy

Varus or valgus alignment or deformity of the knee can abnormally load the medial or lateral compartment, resulting in premature degenerative change in that compartment. Osteotomy aims to divide the bone, correct the deformity and alter the load-bearing mechanics of the joint. The most commonly performed operation is a high tibial osteotomy (HTO) for a varus knee. Realignment is achieved with either an opening-wedge medial HTO or a closing-wedge lateral HTO. The amount of angular correction is calculated preoperatively and then created in theatre with jigs under radiographic control. Fixation with modern plates and locking screws allows early weight-bearing and mobilisation. The ideal patient for osteotomy is a young, active and well-motivated individual with disease limited to one compartment.

(b) Figure 40.4 Anteroposterior (a) and lateral (b) radiographs of a uni compartmental knee replacement.

Osteotomy

Varus or valgus alignment or deformity of the knee can abnormally load the medial or lateral compartment, resulting in premature degenerative change in that compartment. Osteotomy aims to divide the bone, correct the deformity and alter the load-bearing mechanics of the joint. The most commonly performed operation is a high tibial osteotomy (HTO) for a varus knee. Realignment is achieved with either an opening-wedge medial HTO or a closing-wedge lateral HTO. The amount of angular correction is calculated preoperatively and then created in theatre with jigs under radiographic control. Fixation with modern plates and locking screws allows early weight-bearing and mobilisation. The ideal patient for osteotomy is a young, active and well-motivated individual with disease limited to one compartment.

(b) Figure 40.4 Anteroposterior (a) and lateral (b) radiographs of a uni compartmental knee replacement.