Double-Row Root Repair with Bridging Centralization Using Double Nonsliding Anchors for Medial Meniscus Posterior Root Tear.

Medial meniscal posterior root tears disrupt the "hoop" function of the meniscus and may lead to knee osteoarthritis. Although root repair could be a key to osteoarthritis prevention, this surgery does not necessarily guarantee an optimal result even when combined with meniscal centralization and high tibial osteotomy. To address this issue, we made five modifications to the original combined approach, namely two anchors to fix the root, instead of one; bridging centralization instead of single centralization; release of the meniscotibial capsule vs no release; release of valgus stress before knot tying vs no release; and prohibiting postoperative cross-legged sitting and sitting on heels.

Derotational Hybrid Closed-Wedge High Tibial Osteotomy for Knee Osteoarthritis With Patellar Subluxation Caused by Tibial Torsional Deformity.

Patellar subluxation and recurrent dislocation are commonly treated with medial patellofemoral ligament reconstruction, and patients with predisposing factors for these problems often require additional bony realignment procedures. However, these procedures mainly address problems in the axial plane, and patients with medial-compartmental knee osteoarthritis may require further realignment in the coronal plane. In this Technical Note article, we introduce our technique for derotational hybrid closed-wedge high tibial osteotomy.

Medial opening wedge high tibial osteotomy for the treatment of medial unicompartmental knee osteoarthritis: A state-of-the-art review.

Medial unicompartmental knee osteoarthritis is a common condition that is frequently associated with significant pain and dysfunction. Medial opening wedge high tibial osteotomy (MOWHTO) offers a unique opportunity to preserve the knee joint and potentially alter the course of the degenerative process. Recent advances in this field of surgery have enabled surgeons to perform a MOWHTO in a safe, reliable and reproducible manner.

Flexion Contracture in Knee Osteoarthritis Can Be Fully Eliminated by Hybrid Closed Wedge High Tibial Osteotomy Using a Reduction-Insertion-Compression Handle.

In conventional closed-wedge high tibial osteotomy (CWHTO) with preservation of the medial hinge, flexion contracture cannot be improved because of the two-dimensional correction. Conversely, in hybrid CWHTO, for which the name is derived from a hybrid of the lateral closing and medial opening, the medial cortex is intentionally disrupted. The medial hinge disruption enables three-dimensional correction, which helps eliminate flexion contracture by decreasing posterior tibial slope (PTS).

Femoral-varus tibial-valgus osteotomy (FVTVO) for neutrally-aligned knee osteoarthritis with severe joint line obliquity enables return to sports activities: A case series study.

Background: Re-alignment surgeries for uni-compartmental knee osteoarthritis, such as high tibial osteotomy (HTO) for varus knees or distal femoral osteotomy (DFO) for valgus knees, are recognized as standard strategies. However, the treatment strategy has not been established for patients with a neutrally-aligned osteoarthritic knee with severe joint line obliquity (JLO) owing to the combination of a valgus femur and a varus tibia; i.e.

Proximal tibiofibular joint (PTFJ) dislocation due to Ehlers-Danlos syndrome: posterolateral open-wedge high tibial osteotomy combined with medial closed-wedge distal femoral osteotomy can correct the severe valgus deformity with a markedly increased tibial posterior slope.

Ehlers-Danlos syndrome (EDS) causes joint hypermobility and joint dislocation. Since there are no reports of proximal tibiofibular joint (PTFJ) dislocation caused by EDS, little is known about the long-term course of this disease. A woman in her 40s presented with a posterolaterally depressed tibial condyle and severe valgus deformity caused by a long-standing PTFJ dislocation due to EDS.

Around-knee osteotomy conversion for failed high tibial osteotomy: Re-correction high tibial osteotomy and additional distal femoral osteotomy may enable return to sporting activities.

High tibial osteotomy (HTO) for knee osteoarthritis achieves excellent short- and long-term results. However, failure of HTO due to undercorrection or correction loss may necessitate conversion surgery. For patients with HTO failure who desire a return to sporting activities (RTS), non-prosthetic joint-preserving solutions such as conversion to around-knee osteotomies (AKO-conversion) may be more appropriate than total knee arthroplasty.

Open Wedge High Tibial Osteotomy with Pes Anserinus Preservation and Insertion of Bone Substitutes.

Biplanar open wedge high tibial osteotomy (OWHTO) has become common since the introduction of OWHTO-specific plates. However, the management of soft tissues, including skin, the pes anserinus, and the superficial medial collateral ligament (sMCL) release vary among surgeons. We introduce an OWHTO methodology that avoids pes incision and repair, uses bone substitute insertion into the opening gap and includes management of soft tissues to minimize complications.

High tibial osteotomy solely for the purpose of return to lifelong sporting activities among elderly patients: A case series study.

Knee osteoarthritis (KOA) is a common joint disease among older individuals, associated with increased mortality rates. The current study was conducted to examine whether open wedge high tibial osteotomy (OWHTO) is an effective treatment for elderly patients with a desire to return to sporting activities (RTS) who do not report inconvenience or pain in activities of daily living. We examined a case series of 9 KOA patients (12 knees) aged 50 or above with a desire for RTS, who underwent HTO.

Additional distal femoral osteotomy for insufficient correction after high tibial osteotomy.

A 70-year-old man who was treated with a closed-wedge high tibial osteotomy (HTO) had recurrent right medial knee pain 12 years after the initial osteotomy. We planned a recorrection osteotomy because the patient led an active lifestyle, had well-preserved range of motion and the lateral compartment was still intact. According to preoperative deformity analysis, which indicated a tibia in slight valgus and a femur in moderate varus, recorrection of the distal femur was chosen.