Understanding Osteotomy: A narrative review

Journal of Clinical Orthopaedics | Vol 5 | Issue 1 |  Jan-Jun 2020 | page: 21-30 | Domenico Alesi, Vito Gaetano Rinaldi, Amit Meena, Giulio Maria Marcheggiani Muccioli, Stefano Zaffagnini


Author: Domenico Alesi [1], Vito Gaetano Rinaldi [1], Amit Meena [2], Giulio Maria Marcheggiani Muccioli [1,3], Stefano Zaffagnini [1,3]

[1] 2nd Orthopaedic and Traumatology Clinic – IRCCS – Istituto Ortopedico Rizzoli – Via G.B. Pupilli 1, 40136, Bologna, Italy.
[2] Central Institute of Orthopaedics, VMMC and Safdarjung Hospital, New Delhi, 110029, India.
[3] DIBINEM, University of Bologna, Bologna, Italy.

Address of Correspondence
Dr. Domenico Alesi,
Resident in Orthopedics and Traumatology, IRCCS – Istituto Ortopedico Rizzoli Via di Barbiano, 1/13, Bologna
E-mail: domenico.alesi@ior.it


Abstract

Osteotomy around the knee is an effective surgical procedure for active, physiologically young patients with symptomatic unicompartmental osteoarthritis (OA) and malalignment. It restores the correct lower limb mechanical alignment, redistributing weight-bearing from a damaged joint surface area to an undamaged one. Hence, it consistently provides relief in knee pain, improves knee function, and delay the need for TKA. Despite all these advantages its popularity was decreasing in the past but improved meniscal and cartilage restoration techniques renewed interest in knee osteotomies in young patients with knee pain and joint surface defects. Hence, in the last decade, the majority of osteotomies have been performed in combined with cartilage repair, meniscal transplantation, and ligament reconstruction. Understanding the rationale of an osteotomy and the possibility to combine it with other procedures allows us to obtain the most clinical benefit for the patient. This review article provides an overview of the basic osteotomy planning for knee axes malalignment, describing the different techniques based on the location of the deformity and the presence of associated lesions, thus presenting the main results of isolated and combined procedures, to provide useful updates to guide the surgeon in the choice of possible variants or associated gestures.
Keywords: Deformities around the knee, High tibial osteotomy, Clinical outcome.


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How to Cite this article: Alesi D, Rinaldi VG, Meena A, Muccioli GMM, Zaffagnini S | Understanding osteotomy: a narrative review | Journal of Clinical Orthopaedics | January-June 2020; 5(1):21-30.

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