This review explores the intricate relationship between knee osteotomy and frontal plane joint line orientation, emphasizing the dynamic nature of the joint line's influence on knee forces and kinematics. Consideration of coronal alignments, knee phenotypes, and associated angles (medial proximal tibial angle (MTPA), lateral distal femoral angle (LDFA), joint line convergence angle (JLCA)) becomes crucial in surgical planning to avoid joint line deformities. The double-level osteotomy is to be considered a valid option, especially for severe deformities; however, the target patient cannot be selected solely based on high predicted postoperative joint line obliquity (JLO) and MPTA.
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http://dx.doi.org/10.1530/EOR-24-0037 | DOI Listing |
Arch Orthop Trauma Surg
January 2025
Medical University of Graz, Graz, Austria.
Background: The role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine.
View Article and Find Full Text PDFDan Med J
November 2024
Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital - Amager and Hvidovre Hospital, Denmark.
Introduction: High tibial osteotomy (HTO) is used to treat medial knee osteoarthritis (OA). A simple clinical test to select the patients most likely to benefit from the procedure was suggested by R. A.
View Article and Find Full Text PDFBMC Musculoskelet Disord
January 2025
Department of Orthopedic Surgery, The 3rd Hospital of Hebei Medical University, Hebei, Shijiazhuang, 050051, P.R. China.
Background: It is known that open wedge high tibial osteotomy (OWHTO) may lead to progression of patellofemoral degeneration due to descent of the patellar height. However, the difference in patellofemoral joint (PFJ) loads with normal daily activity between uniplane and biplane osteotomies is unclear. The purpose of this study was to reveal the differences in PFJ biomechanics between uniplane and biplane OWHTO using finite element analysis (FEA).
View Article and Find Full Text PDFOsteotomies around the knee have a variety of indications, including pain reduction, functional improvement, knee joint stabilization, and articular cartilage preservation. Thorough preoperative planning is essential, including a determination of the precise location of any deformity (proximal tibia, distal femur, or both). High tibial osteotomies and distal femoral osteotomies can be performed in isolation, or jointly in the form of a double-level osteotomy, for correction of coronal and/or sagittal deformity of the knee.
View Article and Find Full Text PDFOsteochondral and chondral injuries of the patellofemoral joint are common in active patients, and effective management requires a thorough physical and imaging evaluation, a detailed understanding of the unique anatomic and biomechanical joint properties contributing to these injuries, and an appropriate selection of treatment modality. Diagnosis of patellofemoral chondral injuries can be challenging, and differentiating between various causes of anterior knee pain is crucial to successful outcomes. Once identified, nonsurgical treatments including physical therapy, bracing, and injections are a mainstay of initial management.
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