Osteotomy About the Knee: International Roundtable Discussion

Chapter 96 Osteotomy About the Knee


International Roundtable Discussion



Osteotomy about the knee has traditionally been used to treat the middle-aged patient with gonarthrosis, but the indications have broadened to include the younger patient or athlete with ligament deficiencies, chondral defects, absent menisci, or posttraumatic degenerative arthritis. We have assembled a panel of experts that includes Michael Stuart (moderator), David Backstein, Martin Logan, and Thomas Muellner, who will share their personal ideas and preferences based on extensive experience with this procedure.




















Michael Stuart


I don’t have any experience with osteotomy computer navigation, but it may be helpful for intraoperative verification of multiplanar corrections in complex cases. I routinely use the weight-bearing line method because it is a simple and reproducible technique for determining the desired coronal plane correction angle (Fig. 96-1) (see Dugdale TW, Noyes FR, Styer D: Preoperative planning for high tibial osteotomy: the effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264, 1992). The surgeon chooses the desired coordinate, which equals the angle of correction according to the specific clinical situation (typically 62%; range, 50% to 75%). Remember that standing radiographs can overestimate the magnitude of correction as the result of osseous defects and/or attenuated ligaments. Compare the amount of lateral joint space opening (in millimeters) with the contralateral knee and subtract the difference from the calculated angle (1 degree per millimeter) to avoid overcorrection.



The lateral closing wedge osteotomy of the proximal tibia was the procedure of choice in the past to correct a varus deformity. In recent years with the advent of new implant designs, the medial opening wedge technique has become popular.




Aug 26, 2016 | Posted by in ORTHOPEDIC | Comments Off on Osteotomy About the Knee: International Roundtable Discussion

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