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Biplanar opening-wedge tibial valgus osteotomy for medial knee OA: Review of 20 year’s experience with tips and tricks

Published in N°015 - January / February 2022
Article viewed 98 times

Biplanar opening-wedge tibial valgus osteotomy for medial knee OA: Review of 20 year’s experience with tips and tricks

By Thomas R. Henkel, Alex E. Staubli in category SURGICAL TECHNIQUE
Hirslanden Andreas Klinik Cham Zug, Rigistrasse 1, 6330 Cham, Schweiz / [email protected] / [email protected]

Frontal plane leg alignment correction is an important pillar of treatment during joint-sparing knee surgery for medial gonarthritis. A varus deformity of the knee joint represents a significant risk factor for the development and further progression of medial cartilage lesions.

Introduction

Frontal plane leg alignment correction is an important pillar of treatment during joint-sparing knee surgery for medial gonarthritis. A varus deformity of the knee joint represents a significant risk factor for the development and further progression of medial cartilage lesions [1−3]. Tibial valgus osteotomy, potentially in combination with femoral osteotomy (double osteotomy) has gained significant importance in the past few years, thanks to improved planning and fixation techniques with locking plates. Whereas lateral closing wedge tibial plateau osteotomy was the preferred surgery method in the past, today it is medial open-wedge biplanar tibial valgus osteotomy with a locking plate implant [4−9]. The number of relevant complications could also be reduced using locking implants and refined surgery techniques [10].

Good long-term outcomes can be expected with careful patient selection and precise surgical technique [11]. The authors are presenting a practice-oriented algorithm with tips and tricks of a medial open-wedge biplanar tibial valgus osteotomy based on more than 20 years of experience.

 

Patient selection

Indication for valgus osteotomy of the knee

  • Symptomatic patient with Outerbridge Grade 1−3 cartilage lesions [12] of the medial compartment with...

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