151. Inverted V–Shaped High Tibial Osteotomy for Medial Osteoarthritic Knees With Severe Varus Deformity
- Author
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Masayuki Inoue, Yoshimitsu Aoki, Norimasa Iwasaki, Koji Yabuuchi, Kazunori Yasuda, Eiji Kondo, and Tomonori Yagi
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,medicine.medical_treatment ,Osteoarthritis ,Osteotomy ,03 medical and health sciences ,0302 clinical medicine ,High tibial osteotomy ,Technical Note ,Deformity ,medicine ,Orthopedics and Sports Medicine ,Tibia ,Instant centre of rotation ,Varus deformity ,Orthopedic surgery ,030222 orthopedics ,biology ,business.industry ,030229 sport sciences ,biology.organism_classification ,medicine.disease ,musculoskeletal system ,Surgery ,Valgus ,medicine.symptom ,business ,RD701-811 - Abstract
A hemi-closing-wedge and hemi-opening-wedge, inverted V-shaped high tibial osteotomy with local bone graft has been reported to be an effective surgical procedure for medial osteoarthritis of the knee. In this procedure, an inverted V-shaped osteotomy is made and a thin wedged bone block is resected from the lateral side and implanted in the medial opening space created after valgus correction. This procedure can provide sufficient valgus correction of the knee with severe varus deformity more easily than can closing-wedge high tibial osteotomy. The inverted V-shaped osteotomy does not change the posterior tibial slope, the patellar height, or the length of the lower limb at all because the center of tibial alignment correction by the inverted V-shaped osteotomy is located near the center of rotation of angulation of the lower-limb deformity. We recently modified this procedure by performing biplanar osteotomy, developing useful cutting guides, and fixing the tibia with a lateral locking compression plate. The surgical technique is described to enable the reproducible creation of the hemi-closing-wedge and hemi-opening-wedge, inverted V-shaped osteotomy with the locking plate for medial osteoarthritic knees with moderate or severe varus deformity.
- Published
- 2018