Osteotomies

Question 1

Aim of High tibial osteotomy

Answer 1

Unload medial compartment to
- reduce pain
- slow the degenerative process
in an attempt to slow the degenerative process

Question 2

Aim of High tibial osteotomy

Answer 2

Unload medial compartment to
- reduce pain
- slow the degenerative process
in an attempt to slow the degenerative process

Question 3

Lateral closing wedge HTO

Answer 3

Soft tissue exposure risks damage to common peroneal nerve

Requires a fibular osteotomy or release of the proximal tibiofemoral joint

2 saw cuts

Can cause tibial shortening and offset to the proximal tibia

Mal-alignment only correctable in one plane

Question 4

Medial open wedge HTO

Answer 4

May need bone graft or substitute

1 saw cut (uniplanar) or 2 saw cuts (biplanar)

Can cause tibial lengthening

Allows correction of coronal mal-alignment and tibial slope

Fixation methods have to be able to withstand axial and torsional forces in the proximal tibia

Question 5

Aim of distal femoral osteotomy

Answer 5

Correction of valgus mal-alignment and to unload the lateral compartment OA