Tibial Osteotomy
The practitioner might perform a valgus producing proximal tibial osteotomy in patients with symptomatic medial compartment osteoarthritis of the knee.
LIMITED RECOMMENDATION Rationale
Nine low-strength case series studies found nine out of 10 outcomes significantly improved from baseline. A cross-sectional time series regression analysis was used to predict the placebo effect on VAS pain for comparison to that of the treatment group. Compared to the predicted placebo effect on VAS pain, the proximal tibial osteotomy group reported decreased pain on the VAS.
Based on a lack of appropriate studies, distal femoral (varus producing) osteotomy was not evaluated.
Based on a lack of appropriate studies, distal femoral (varus producing) osteotomy was not evaluated.
- (128) Brouwer RW, Bierma-Zeinstra SM, van Raaij TM, Verhaar JA. Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate. A one-year randomised, controlled study. J Bone Joint Surg Br 2006;88(11):1454-1459. PM:17075089
- (129) Song IH, Song EK, Seo HY, Lee KB, Yim JH, Seon JK. Patellofemoral Alignment and Anterior Knee Pain After Closing- and Opening-Wedge Valgus High Tibial Osteotomy. Arthroscopy 2012. PM:22520445
- (130) Pongsoipetch B, Tantikul C. Open-wedge high tibial osteotomy in varus knee osteoarthritis: a 5-year prospective cohort study. J Med Assoc Thai 2009;92 Suppl 6):S109-S114. PM:20128075
- (131) El-Azab HM, Morgenstern M, Ahrens P, Schuster T, Imhoff AB, Lorenz SGF. Limb alignment after open-wedge high tibial osteotomy and its effect on the clinical outcome. Orthopedics 2011;34(10):e622-e628.
- (132) Rudan JF, Simurda MA. High tibial osteotomy. A prospective clinical and roentgenographic review. Clin Orthop Relat Res 1990;(255):251-256. PM:2347159
- Niemeyer P,Schmal H,Hauschild O,von HJ,Sudkamp NP,Kostler W. Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy 2010 Dec;26(12):1607-1616.
- Saragaglia D,Blaysat M,Inman D,Mercier N. Outcome of opening wedge high tibial osteotomy augmented with a Biosorb((R)) wedge and fixed with a plate and screws in 124 patients with a mean of ten years follow-up. Int Orthop 2010 Jul 29:.
- Schroter S,Gonser CE,Konstantinidis L,Helwig P,Albrecht D. High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate (Position HTO plate) without bone substitute. Arthroscopy 2011 May; 27(5):644-652.