N°19 - September / October 2022
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High tibial osteotomy vs. unicondylar arthroplasty: clearly not two for the same!
By Peter Buschner(1), Christian Benignus(2), Malin Kristin Meier(3), Johannes Beckmann(1) in category REVIEW
(1) Department of Orthopedic Surgery and Traumatology, Hospital Barmherzige Brüder Munich, Romanstr. 93, 80639 Munich - (2) Department of Traumatology and Orthopedic Surgery, Hospital Ludwigsburg, Posilipostr. 4, 71640 Ludwigsburg - (3) Departement of Orthopedic Surgery and Traumatology, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 4, 3010 Bern, Switzerland / [email protected]
High tibial osteotomy (HTO) and the implantation of a medial unicondylar knee arthroplasty (UKA) are very popular in symptomatic medial knee arthropathy and provide reliably good results - assuming that the indication and application are appropriately correct. Medial knee joint osteoarthritis occurs more frequently than its lateral counterpart by a factor of 10. It is known that a constitutional varus deformity of the tibia leads to a faster progression of osteoarthritis development in the case of cartilage damage than in the comparative collective with physiological axis ratios, so that an axis correction can counteract this process [1, 2]. Both procedures have their respective independent indications, and the decision to use one or the other is subject to clear preconditions. Overlaps in indications are rare and must be weighed against each other, with criteria such as patient age, constitution, life circumstances and the expertise of the surgeon playing a role. Furthermore, both are not intermediate solutions on the way to total joint replacement but are procedures with excellent long-term results in their respective fields. However, and again both, a big issue is conversion of failed HTO or UKA to TKA, resulting in worse results, frequent need of revision...
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