دانلود رایگان مقاله استئوتومی پروگزیمال تیبیا گوه باز

Abstract

Varus knee malalignment caused by medial compartment arthritis results in progressive asymmetric wear of the tibiofemoral joint. This wear can cause progressively painful gonarthrosis. Surgical methods to address varus knee malalignment include lateral closing-wedge proximal tibial osteotomy, medial opening-wedge osteotomy, and arthroplasty. Medial opening-wedge proximal tibial osteotomy is an effective procedure for restoring proper coronal alignment and reducing knee pain. In this technical note, we present a reproducible technique for proximal tibial osteotomy. The authors report the following potential conflict of interest or source of funding: A.K. receives support from Arthrex, Arthritis Foundation, and Histogenics. M.J.S. receives support from Arthrex, Stryker, and the American Journal of Sports Medicine (editorial or governing board).

Discussion

Studies show promising results regarding alignment correction, pain relief, and functional outcome, with excellent or good results identified in 90% to 96% of patients at 5 years, 45% at 10 years, and failures occurring at an average of 7 years after surgery because of recurrent knee pain.2,3 The importance of adequate correction has been established, but it can be difficult with some techniques showing either over- or undercorrection in up to 50% of patients.4 Radiographic analysis of the iBalance system identi- fied a 38% overcorrection and 0% undercorrection defined as >10% difference compared with the target weight-bearing line ratio. The biplanar alignment guide helps reduce the amount of over- and undercorrection of knee misalignment. This system did not alter the tibial slope and only slightly decreased patellar height.5