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Total Knee Replacement After High Tibial Osteotomy

Volume 6 | Issue 2 | July-December 2021 | Page 54-57 | Vijay C. Bose , Kalaivanan Kanniyan

DOI:10.13107/aja.2021.v06i02.035


Author: Vijay C. Bose [1], Kalaivanan Kanniyan [1]

[1] Asian-Joint Reconstruction Institute (AJRI), SIMS, Chennai, Tamil Nadu, India.

Address of Correspondence:

Dr. Vijay Bose,
Asian-Joint Reconstruction Institute (AJRI), SIMS, Chennai, Tamil Nadu, India.
E-mail: bose5vijay@hotmail.com


Abstract

Total Knee Arthroplasty (TKA), post High Tibial osteotomy (HTO) continues to be an enigma with published reports of both good and suboptimal results in comparison to TKA for osteoarthritis (OA). The surgeons performing HTO must always employ TKR friendly techniques so that it is easy to apply the correct principles while conversion into TKA and have a very good results contradictory to the traditional historical conclusion. The bug bear of HTO is the post slope where common errors can occur even when performed by experienced surgeons. The norm is usually for the post slope to increase with the medial open wedge and for the post slope to decrease with lateral Closed wedge. The golden rule in Post HTO TKA conversion is to start off by resecting less bone. This is done so that inadvertent joint line variation from ideal is avoided. We then do extension space management by using various thickness of spacer hemi blocks. However individual cases may be different. Reliable results can be achieved in post HTO TKR if good planning and careful execution of the potentially problematic steps are undertaken. Residual soft tissue laxity necessitating increased constraint is more common in Post HTO TKR than in TKR for OA.
Keywords: Total Knee Replacement, High Tibial Osteotomy, Osteoarthritis


References

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How to Cite this article: Bose VC, Kanniyan K | Total Knee Replacement After High Tibial Osteotomy | Asian Journal of Arthroscopy | July-December 2021; 6(2): 54-57.


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Opening Wedge High Tibial Osteotomy

Volume 6 | Issue 2 | July-December 2021 | Page 20-26 | Parag Sancheti, Sunny Gugale, Kailash Patil, Ashok Shaym

DOI:10.13107/aja.2021.v06i02.030


Author: Parag Sancheti [1], Sunny Gugale [1], Kailash Patil [1], Ashok Shaym [1, 2]

[1] Department of Orthopaedics, Sancheti Institute for Orthopaedics & Rehabilitation & PG College, Pune, Maharashtra, India.
[2] Indian Orthopaedic Research Group, Thane, Maharashtra, India.

Address of Correspondence:

Dr. Parag Sancheti,
Dean, Professor & Chairman, Sancheti Institute for Orthopaedics & Rehabilitation & PG College, Pune, Maharashtra, India.
E-mail: sanchetipk@gmail.com


Abstract

In the era of Joint replacement surgery, Medial High Tibial Osteotomy is a time tested and successful surgical procedure for treatment of mild to moderate knee osteoarthritis. The success of this procedure lies in proper patient selection, an excellent surgical technique, a rigid internal fixation and early rehabilitation. There are a lots of research articles published in literature, many systematic reviews and meta-analysis on this specific topic. In this review article we discuss mainly the recent trends in the medial open wedge osteotomy for treatment of knee osteoarthritis.

Keywords: MOWHTO, Osteoarthritis, Osteotomy, Surgical treatment


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How to Cite this article: Sancheti P, Gugale S, Patil K, Shaym A | Opening wedge high tibial osteotomy | Asian Journal Arthroscopy | July-December 2021; 6(2): 20-26.


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Indications for High Tibial Osteotomy

Volume 6 | Issue 2 | July-December 2021 | Page 3-7 | Clement Joseph, Yugal Varandani

DOI: 10.13107/aja.2021.v06i02.027


Author: Clement Joseph [1], Yugal Varandani [1]

[1] Department of Arthroscopy & Sports Medicine, Asian Joint Reconstruction Institute, SIMS, Chennai, Tamil Nadu, India.

Address of Correspondence:
Dr. Clement Joseph,
Senior Consultant & Head, Arthroscopy & Sports Medicine, Asian Joint Reconstruction Institute, SIMS, Chennai, Tamil Nadu, India.
E-mail: clementorth@yahoo.co.in


Abstract

There is a resurgence of interest in HTO to treat young to middle aged patients with varus alignment and isolated medial joint osteoarthritis. With improvements in implant design and preoperative planning methods, good outcomes are reported in multiple studies. But the most important factor for a successful outcome is patient selection. The ideal patient would be a middle-aged patient with isolated medial joint arthritis with good range of movements, non-smoker and with reasonable functional status of knee. The indications of HTO are evolving to include patients in higher age groups, with minimal to moderate patellofemoral symptoms and varying amounts of flexion deformities. It is also increasingly being performed as a joint protective surgery following meniscus repairs and cartilage repair procedures and to correct abnormal joint alignment following neglected ligamentous injuries.


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How to Cite this article: Joseph C, Varandani Y | Indications for High Tibial Osteotomy | Asian Journal of Arthroscopy | July-December 2021; 6(2): 03-07


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