Patient-specific cutting guides allow 1° precision in asymmetric anterior closing-wedge osteotomy.

Purpose: Asymmetric anterior closing-wedge high tibial osteotomy (ACWHTO) allows correction of both excessive posterior tibial slope (PTS) and varus deformity. However, the complexity of this surgery requires a high degree of accuracy, which is less likely to be achieved with standard instrumentations. This study aimed to determine the accuracy of 3D patient-specific cutting guides (PSCGs) to provide the accurate planned correction in the frontal and sagittal planes.

Medial posterior tibial slope measurements are overestimated on long radiographs and 3D CT compared to measurements on short lateral radiographs.

Purpose: This study assessed the measurements of the medial posterior tibial slope (MPTS) using long radiographs and three-dimensional (3D) computed tomography (CT) scans and compared them to measurements taken on short lateral knee radiographs. The study aimed to identify whether the at-risk slope measurements previously defined on the short radiographs would be similar to long radiographs and 3D CT scans.

Methods: A retrospective radiological review of 52 cases, who underwent planning for a slope-changing high tibial osteotomy and had short and long lateral radiographs and 3D CT scans of the tibia.

Maintenance of Coronal Alignment and Joint Line Obliquity Has No Effect on Unicompartmental Knee Arthroplasty: Clinical Results at Five Years Follow-Up.

Background: The applicability of the coronal plane alignment of the knee (CPAK) classification for unicompartmental knee arthroplasty (UKA) is not yet clear. The current study aimed to address the following questions: 1) what is the distribution of the CPAK classification among patients who underwent medial UKA? and 2) what would be the clinical outcomes for patients whose coronal alignment and joint line obliquity have either changed or been maintained postoperatively?

Methods: This retrospective study involved 325 patients treated with fixed-bearing medial UKA between 2017 and 2019 following a kinematic alignment strategy and using cemented resurfacing implants. Long-leg standing radiographs were utilized for all preoperative and postoperative measurements.

Alignment rod and gap measurement methods achieve comparable alignment correction in opening wedge high tibial osteotomy for varus osteoarthritic knees.

Purpose: To compare clinical and radiological outcomes of medial opening wedge high tibial osteotomy (MOWHTO) using two different alignment methods: the alignment rod (AR) versus the gap measurement (GM) method. The primary outcome was to report the surgical accuracy of coronal plane corrections in each method.

Methods: Patients who underwent MOWHTO with either AR or GM method between 2014 and 2022 at a single institution, with a minimum of 2 years of follow-up, were included.

Superior accuracy in knee double level osteotomy using a novel hybrid fixation technique compared to conventional double plating.

Purpose: This study aimed to compare two different double-level knee osteotomy (DLO) fixation techniques. The primary outcome reported the radiological coronal plane correction and its accuracy. The secondary outcomes reported the correction outliers, the clinical outcomes, the 5-year postoperative satisfaction and the complications.

Medial opening wedge high tibial osteotomy performs similarly irrespective of body mass index.

Purpose: This study investigates the effect of the body mass index (BMI) on the early (2 years) to midterm (5 years) results of medial opening wedge high tibial osteotomy (MOWHTO).

Methods: A prospectively maintained single-centre database of 1138 knee osteotomies, between 2002 and 2022, was retrospectively reviewed. Adult patients who underwent MOWHTO for symptomatic unicompartmental medial knee osteoarthritis (OA), with varus knee malalignment, having failed conservative management, were included.

Should I add orthobiologics to my knee osteotomy practice? A systematic review.

Importance: Orthobiologics has seen a renaissance over the last decade as an adjunct therapy during osteotomy due to the limited inherent regenerative potential of damaged intraarticular tissues.

Aim Or Objective: This systematic review aims to present the latest evidence regarding using orthobiologics with simultaneous high tibial osteotomy (HTO) for knee osteoarthritis. The results of this study may guide surgeons to improve their clinical results and clear the air regarding confusion over whether or not to add orthobiologics to HTO in clinical practice backed by scientific evidence.

Surgical strategy and complication management of osteotomy around the painful degenerative varus knee: ESSKA Formal Consensus Part II.

Purpose: The purpose of the European consensus was to provide recommendations for the treatment of patients with a painful degenerative varus knee using a joint preservation approach. Part II focused on surgery, rehabilitation and complications after tibial or femoral correction osteotomy.

Methods: Ninety-four orthopaedic surgeons from 24 countries across Europe were involved in the consensus, which focused on osteotomies around the knee.

Osteotomy around the painful degenerative varus knee has broader indications than conventionally described but must follow a strict planning process: ESSKA Formal Consensus Part I.

Purpose: The European consensus was designed with the objective of combining science and expertise to produce recommendations that would educate and provide guidance in the treatment of the painful degenerative varus knee. Part I focused on indications and planning.

Methods: Ninety-four orthopaedic surgeons from 24 European countries were involved in the consensus, which focused on the most common indications for osteotomy around the knee.

Deformity in valgus knee malalignment is not only in the femur but also in tibia or both, based on demographic and morphological analysis before and after knee osteotomies.

Purpose: This study aims to identify the demographic and morphological features of valgus knee deformity with unilateral osteoarthritic knee in the coronal plane. A secondary aim was to identify the distinct phenotypes of valgus knees in Hirschmann's phenotype and the coronal plane alignment of the knee (CPAK) classifications before and after a knee osteotomy (KO).

Methods: A total of 107 patients (57 female and 50 male) with a mean age of 42.

The tipping point in medial opening wedge high tibial osteotomy relates to the shape of the proximal tibia more than to lower limb alignment correction.

Purpose: The tipping point (TP) of the knee joint is the centre of rotation of the joint in the coronal plane. This study aimed to define the TP in medial opening wedge high tibial osteotomy (MOWHTO).

Methods: Data from 154 consecutive patients with varus knee malalignment, who underwent MOWHTO between 2017 and 2021, was retrospectively reviewed.

Combined knee osteotomy and cartilage procedure for varus knees: friend or foe? A narrative review of the literature.

Varus knees with associated cartilage pathologies are not uncommon scenarios that present to orthopaedic surgeons. There is no agreement on the ideal management of varus knees with concomitant cartilage pathology. Through a literature review, the authors tried to answer three main questions: On October 2022, OVID MEDLINE, EMBASE, and COCHRANE databases were searched.

High survivorship and low complication rate in a single-centre series of 651 medial opening wedge high tibial osteotomy cases with a mean follow-up of 13 years.

Purpose: This study aimed to report the early to midterm results of medial opening wedge high tibial osteotomy (MOWHTO) from the largest single-centre osteotomy database. The primary outcomes were reporting the radiological corrections and the functional outcomes represented by multiple patient-reported outcome measures (PROMs). The secondary outcomes were to report the complications, revisions and survivorship up to 10 years postoperatively.