Are you a High Tibial Osteotomy Candidate?

Doctor

In the normal Knee, loads that are 2-4 times body weight are imposed on the tibiofemoral joint. 60% of the load passes through the medial compartment. In a unicompartmental OA, the altered limb alignment causes the load to be distributed more on the affected compartment, which may accelerate degenerative process and cause pain; Osteotomy redistributes the loads to the uninvolved compartment.

Any person below 60 years of age having unicompartmental (medial or lateral compartment) osteoarthritis of the knee, is well suited for this procedure.

Prerequisites to get a HTO done:

  1. Physiological age below 60 years.
  2. Physically active in a demanding profession eg: athlete, gardener (need to kneel).
  3. Less than 15 degrees of fixed varus or 12 degrees of fixed valgus deformity.
  4. Patient should have minimum of 90 degree of flexion.

Results:

The success rates at 10 yrs following Osteotomy are produced when there have been an over correction of the Varus Deformity by 3 to 10 degrees. Progressive Osteoarthritis seems to be the reason for the deterioration of functional outcomes.

Factors associated with late failures of High Tibial Osteotomy:

Older age at the time of the surgery

  • Obesity
  • Less constitutional preopera-tive tibial varus (<5°)
  • Advanced Femorotibial Osteoarthritis of the medial compartment with more than 50% reduction in the joint space - severe limitation of motion before surgery.