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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]
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]
In medicine, the Ilizarov apparatus is a type of external fixation apparatus used in orthopedic surgery to lengthen or to reshape the damaged bones of an arm or a leg; used as a limb-sparing technique for treating complex fractures and open bone fractures; and used to treat an infected non-union of bones, which cannot be surgically resolved.
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.
Surgical treatment is typically indicated for high-energy trauma fractures. [ 1 ] Intramedullary nailing is a common technique, but external fixation may have equivalent outcomes and be preferred under certain patient conditions that may preclude intramedullary nailing, such as the presence of a total knee arthroplasty.
The recovery period may be 12 weeks or longer and may involve the use of mobility aids (e.g. walking frames, canes, crutches) to enable the patient's return to preoperative mobility. [4] It is estimated that approximately 82% of total knee replacements will last 25 years.
Cases of avascular necrosis have been identified in a few high-profile athletes. It abruptly ended the career of American football running-back Bo Jackson in 1991. Doctors discovered Jackson to have lost all of the cartilage supporting his hip while he was undergoing tests following a hip injury he had on the field during a 1991 NFL Playoff ...
[4] [6] Appropriate wound management is important to reduce the high rate of infectious complications and secondary wound healing problems associated with open pilon fractures. [7] Vacuum-assisted wound closure therapy and using a staged protocol (awaiting soft-tissue recovery before extensive reconstructive efforts) may play a positive role.