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Year : 2015  |  Volume : 32  |  Issue : 2  |  Page : 87-91

Evidence-based medicine in high tibial osteotomy for knee osteoarthritis

Department of Orthopaedic Surgery, Faculty of Medicine, Benha University, Benha, Egypt

Correspondence Address:
Ahmed Mohamed Hassanin
BB.Ch, 63 Atlas Qoda, 8 Distinct, 11762, Nasr city, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-208X.180319

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Knee osteoarthritis is the most common joint disorder, and symptomatic disease occurs in 10% of men and 13% of women older than 60 years. Patients with osteoarthritis of the medial compartment often have varus alignment, and the mechanical axis and load-bearing axis pass through the medial compartment. The medial compartment is almost 10 times more frequently involved than that of the lateral compartment. Moreover, varus but not valgus alignment increases the risk for incident tibiofemoral osteoarthritis. An osteotomy is a surgical procedure, which implies that the bone is cut. A correction osteotomy at the knee is used to realign the leg and to transfer the weight-bearing axis from the pathological compartment to the healthy compartment. Patients with osteoarthritis of the medial compartment and varus alignment can be treated with a valgus osteotomy. Several correction osteotomy techniques are available for unicompartmental knee osteoarthritis, such as the closing wedge technique with removal of a wedge of bone, the opening-wedge technique with creation of a wedge, a combined (opening and closing wedge) technique, and techniques that are performed without creating a wedge in the bone, including dome osteotomy and hemicallotasis osteotomy with an external fixator. Unloading will result in slowing down of the osteoarthritis process. In retrospective studies, this procedure resulted in pain relief, improved function, and postponement of knee arthroplasty for 7-20 years, depending on participant selection, stage of osteoarthritis, and achievement and maintenance of adequate operative correction.

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