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High tibial osteotomies in the young active patient

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Abstract

Unicompartmental changes in the knee of a young athlete remains a difficult and controversial problem in orthopaedics. Excessive premature loading of articular cartilage, most often the result of a knee injury, has been shown to result in increased degenerative changes and pain in the younger patient. Instability may also contribute to the degeneration of cartilage and must therefore be considered in the treatment of osteoarthritis in the young adult. High tibial osteotomy has been described as a treatment option for malalignment in the older, less active adult and has shown promising results in a younger, more active population. Osteotomies for instability are more controversial and should be considered in more complex injury patterns.

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References

  1. Jackson JP, Waugh W, Green JP (1969) High tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg 51B:88–94

    Google Scholar 

  2. Matthews LS, Goldstein SA, Malvitz TA, Katz BP, Kaufer H (1988) Proximal tibial osteotomy: factors that influence the duration of satisfactory function. Clin Orthop 229:193–200

    PubMed  Google Scholar 

  3. Holden DL, James SL, Larson RL, Slocum DB (1988) Proximal tibial osteotomy in patients who are fifty years old or less: a long-term follow up study. J Bone Joint Surg 70A:977–982

    Google Scholar 

  4. Coventry MB, Ilstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy: a critical long-term study of eighty seven cases. J Bone Joint Surg Am 75(2):196–201

    CAS  PubMed  Google Scholar 

  5. Aglietti P, Rinonapoli E, Stringa G, Taviani A (1983) Tibial osteotomy for the varus osteoarthritic knee. Clin Orthop 176:239

    PubMed  Google Scholar 

  6. Allen PR, Denham RA, Swan AV (1984) Late degenerative changes after menisectomy. Factors affecting knee after operation. J Bone Joint Surg 66B:666–671

    Google Scholar 

  7. Phillips MJ, Krackow KA (1998) High tibial osteotomy and distal femoral osteotomy for valgus and varus deformity around the knee. Instr Course Lect 47:429–436

    CAS  PubMed  Google Scholar 

  8. Reimann I (1973) Experimental osteoarthritis of the knee in rabbits induced by alterations by alteration of the load-bearing. Acta Orthop Scand 44:496–504

    Article  CAS  PubMed  Google Scholar 

  9. Tetsworth K, Paley D (1994) Malalignment and degenerative arthropathy. Orthop Clin North Am 25:367–377

    CAS  PubMed  Google Scholar 

  10. Wu DD, Burr DB, Boyd RB, Radin EL (1990) Bone and cartilage changes following experimental varus or valgus tibial angulation. J Orthop Res 8:572–585

    Article  CAS  PubMed  Google Scholar 

  11. Coventry M (1985) Upper tibial osteotomy for osteoarthritis. J Bone Joint Surg 67A:1136–1140

    Google Scholar 

  12. Morrey BF (1989) Upper tibial osteotomy for secondary osteoarthritis of the knee. J Bone Joint Surg Br 71:554–559

    CAS  PubMed  Google Scholar 

  13. Markolf KL, Bargar WL, Shoemaker SC, Amstutz HC (1981) The role of joint load in knee stability. J Bone Joint Surg 63(4):570–585

    CAS  PubMed  Google Scholar 

  14. Tigani D, Ferrari D, Trentani P, Barbanti-Brodano G, Trentani F (2001) Patellar height after high tibial osteotomy. Int Orthop 24:331–334

    Article  CAS  PubMed  Google Scholar 

  15. Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop 274:248–264

    PubMed  Google Scholar 

  16. Amendola A, Mrkonjic L, Clatworthy M, Kirkley A, Litchfield RB, Fowler PJ (1999) Opening wedge high tibial osteotomy using a Puddu distraction plate; focus on technique, early results and complications. Arthroscopy 15(5):S35

    Google Scholar 

  17. Amendola A, Bonasia DE (2009) Results of high tibial osteotomy: review of the literature. Int Orthop. doi:10.1007/s00264-009-0889-8

  18. Aglietti P, Buzzi R, Vena LM (2003) High tibial osteotomy for medial gonarthrosis: a 10- to 21-year study. Am J Knee Surg 16(1):21–26

    Google Scholar 

  19. Billings A, Scott DF, Camargo MP, Hofmann AA (2000) High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion: long-term follow-up. J Bone Joint Surg Am 82(1):70–79

    CAS  PubMed  Google Scholar 

  20. Naudie D, Bourne RB, Rorabeck CH, Bourne TJ (1999) Survivorship of the high tibial valgus osteotomy: A 10- to 22-year follow-up study. Clin Orthop 367:18–27

    PubMed  Google Scholar 

  21. Koshino T, Yoshida T, Ara Y (2004) Fifteen to twenty-eight years follow-up results of high tibial valgus osteotomy for osteoarthritic knee. Knee 11(6):439–444

    Article  PubMed  Google Scholar 

  22. Sterett WI, Steadman JR (2004) Chondral resurfacing and high tibial osteotomy in the varus knee. Am J Sports Med 32(5):1243–1249

    Article  PubMed  Google Scholar 

  23. Weale AE, Lee AS, MacEachern AG (2001) High tibial osteotomy using a dynamic axial external fixator. Clin Orthop 382:154–167

    Article  PubMed  Google Scholar 

  24. Hernigou P, Ma W (2001) Open wedge tibial osteotomy with acrylic bone cement as bone substitute. Knee 8(2):103–110

    Article  CAS  PubMed  Google Scholar 

  25. Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy with varus deformity: a ten to thirteen year follow-up study. J Bone Joint Surg Am 69:332

    CAS  PubMed  Google Scholar 

  26. Kim S, Pozzi A, Kowaleski MP, Lewis DD (2008) Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 37(2):111–125

    Article  PubMed  Google Scholar 

  27. LaPrade RF, Engebretsen L, Johansen S, Wentorf FA, Kurtenbach C (2008) The effect of proximal tibial opening wedge osteotomy on posterolateral knee instability: a biomechanical study. Am J Sports Med 36(5):956–960

    Article  PubMed  Google Scholar 

  28. Noyes F, Barber-Westin SD, Hewett TE (1999) High tibial osteotomy and ligament reconstruction for varus angulated anterior cruciate ligament-deficient knees. Presented at the 66th annual meeting of the American Academy of Orthopaedic Surgeons, Anaheim, California, February 1999

  29. Arthur A, LaPrade RF, Agel J (2007) Proximal tibial opening wedge osteotomy as the initial treatment for chronic posterolateral corner deficiency in the varus knee: a prospective clinical study. Am J Sports Med 35(11):1844–1850

    Article  PubMed  Google Scholar 

  30. Nelissen EM, van Langelaan EJ, Nelissen RGHH (2009) Stability of medial opening wedge high tibial osteotomy: a failure analysis. Int Orthop. doi:10.1007/s00264-009-0723-3

  31. Phisitkul P, Wolf BR, Amendola A (2006) Role of high tibial and distal femoral osteotomies in the treatment of lateral-posterolateral and medial instabilities of the knee. Sports Med Arthroscopy 14(2):96–104

    Article  Google Scholar 

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Correspondence to Michelle Wolcott.

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Wolcott, M., Traub, S. & Efird, C. High tibial osteotomies in the young active patient. International Orthopaedics (SICOT) 34, 161–166 (2010). https://doi.org/10.1007/s00264-009-0944-5

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