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High tibial osteotomy is an orthopaedic surgical procedure which aims to correct a varus deformation with compartmental osteoarthritis.Since the inception of the procedure, advancements to technique, fixation devices, and a better understanding of patient selection has allowed HTO to become more popular in younger, more active patients hoping to combat arthritis. [1]
Most people with arthritis severe enough to consider knee replacement have significant wear in two or more of the above compartments, and are treated with total knee replacement (TKA). A minority of people with osteoarthritis have wear primarily in one compartment, usually the medial, and may be candidates for unicompartmental knee replacement.
The location of the removed wedge of bone depends on where osteoarthritis has damaged the knee cartilage. The most common type of osteotomy performed on arthritic knees is a high tibial osteotomy, which addresses cartilage damage on the inside (medial) portion of the knee. The procedure usually takes 60 to 90 minutes to perform. [9]
A separate review found that most people would consider a reduction in pain of approximately 12 on the same 0 to 100 scale important—suggesting that for most people, the pain reduction at 3 months is not important. [16] Arthroscopy did not reduce pain or improve function or quality of life at one year. [12] There are important adverse effects ...
One study has shown a success rate of 75 to 80 percent among patients 45 years of age or younger. [21] [22] It is an outpatient procedure and causes only small discomfort. The harder part is the restrictions that are placed on the patient during the post-operative recovery period. This can be a major challenge for many patients.
The article's authors found that the yearly rate of acute compartment syndrome is 1 to 7.3 cases per 100,000 people. [70] It varies greatly by age and gender in trauma. [14] Men are ten times more likely than women to get ACS. [6] The mean age for ACS is 30 in men and 44 in women. [19] People under 35 may get ACS more often.
This is a medial tibial plateau fracture with a split or depressed component. It is usually the result of a high energy injury and involves a varus force with axial loading at the knee. Represent 10% of all tibial plateau fractures. There is high risk of damage to the popliteal artery and peroneal nerve and therefore carry a worse prognosis.
Still, elderly people make up the fastest growing population in the world. As bone mass declines with age, the risk of fractures increases. Annual incidence of osteoporotic fractures is more than 1.5 million in the US and notably 20% of people die during the first year after a hip fracture .