Skip to main content
SpringerLink
Log in

Outcomes of Surgery for Medial Arthrosis

  • Chapter
  • First Online:
Osteotomy About the Knee

  • 478 Accesses

Abstract

The knee is comprised of three articular compartments, and of these the medial compartment is most frequently affected by isolated arthrosis. This can be attributed to 60–70% of weight-bearing load being transmitted through the medial compartment in a normally aligned knee and varus being the most common malalignment [1]. There is a greater incidence of injury to medial structures, with a higher rate of both chondral and meniscal trauma when compared to the lateral side [2]. Chondral injuries have the potential to progress, and a meniscal injury causes disruption to its intrinsic hoop stresses important for load distribution and protection of the joint [3]. Varus malalignment can be accentuated by medial compartment cartilage wear, further increasing the load distribution medially and accelerating osteoarthritis (OA).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol. 2006;20:3–25.

    PubMed  Google Scholar 

  2. Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: a 10-year study. Knee. 2006;13:184–8.

    CAS  PubMed  Google Scholar 

  3. Badlani JT, Borrero C, Golla S, Harner CD, Irrgang JJ. The effects of meniscus injury on the development of knee osteoarthritis: data from the osteoarthritis initiative. Am J Sports Med. 2013;41:1238–44.

    PubMed  Google Scholar 

  4. van der Woude JAD, Spruijt S, van Ginneken BTJ, van Heerwaarden RJ. Distal femoral valgus osteotomy: bone healing time in single plane and biplanar technique. Strategies Trauma Limb Reconstr. 2016;11:177–86.

    PubMed  PubMed Central  Google Scholar 

  5. Wang X, et al. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis. J Int Med Res. 2017;45:282–9.

    PubMed  PubMed Central  Google Scholar 

  6. Parker DA, Beatty KT, Giuffre B, Scholes CJ, Coolican MRJ. Articular cartilage changes in patients with osteoarthritis after osteotomy. Am J Sports Med. 2011;39:1039–45.

    PubMed  Google Scholar 

  7. Duivenvoorden T, et al. Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up. J Bone Joint Surg Am. 2014;96:1425–32.

    CAS  PubMed  Google Scholar 

  8. Wu L, Lin J, Jin Z, Cai X, Gao W. Comparison of clinical and radiological outcomes between opening-wedge and closing-wedge high tibial osteotomy: a comprehensive meta-analysis. PLoS One. 2017;12:e0171700.

    PubMed  PubMed Central  Google Scholar 

  9. Nerhus TK, et al. Radiological outcomes in a randomized trial comparing opening wedge and closing wedge techniques of high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2017;25:910–7.

    PubMed  Google Scholar 

  10. Howells NR, Salmon L, Waller A, Scanelli J, Pinczewski LA. The outcome at ten years of lateral closing-wedge high tibial osteotomy: determinants of survival and functional outcome. Bone Joint J. 2014;96-B:1491–7.

    CAS  PubMed  Google Scholar 

  11. Ekeland A, Nerhus TK, Dimmen S, Thornes E, Heir S. Good functional results following high tibial opening-wedge osteotomy of knees with medial osteoarthritis: a prospective study with a mean of 8.3years of follow-up. Knee. 2017;24:380–9.

    PubMed  Google Scholar 

  12. Brouwer RW, et al. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev. 2014:CD004019. https://doi.org/10.1002/14651858.CD004019.pub4.

  13. Figueroa F, et al. Symptomatic relief in medial opening wedge high tibial osteotomies for the treatment of knee osteoarthritis is influenced by concurrent procedures and preoperative pain level. J ISAKOS Jt Disord Amp Orthop Sports Med. 2018;3:8.

    Google Scholar 

  14. Huizinga MR, Gorter J, Demmer A, Bierma-Zeinstra SMA, Brouwer RW. Progression of medial compartmental osteoarthritis 2-8 years after lateral closing-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2017;25:3679–86.

    CAS  PubMed  Google Scholar 

  15. Baliunas AJ, et al. Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarthr Cartil. 2002;10:573–9.

    CAS  PubMed  Google Scholar 

  16. Lee SH, Lee O-S, Teo SH, Lee YS. Change in gait after high tibial osteotomy: a systematic review and meta-analysis. Gait Posture. 2017;57:57–68.

    PubMed  Google Scholar 

  17. Leitch KM, Birmingham TB, Dunning CE, Giffin JR. Medial opening wedge high tibial osteotomy alters knee moments in multiple planes during walking and stair ascent. Gait Posture. 2015;42:165–71.

    PubMed  Google Scholar 

  18. Morin V, et al. Gait analysis following medial opening-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2018;26:1838–44.

    PubMed  Google Scholar 

  19. McClelland D, et al. Medium- and long-term results of high tibial osteotomy using Garches external fixator and gait analysis for dynamic correction in varus osteoarthritis of the knee. Bone Joint J. 2016;98-B:601–7.

    CAS  PubMed  Google Scholar 

  20. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am. 1979;10:585–608.

    CAS  PubMed  Google Scholar 

  21. Sprenger TR, Doerzbacher JF. Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J Bone Joint Surg Am. 2003;85-A:469–74.

    Google Scholar 

  22. Lansdaal JR, et al. Early weight bearing versus delayed weight bearing in medial opening wedge high tibial osteotomy: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2017;25:3670–8.

    PubMed  Google Scholar 

  23. Gaasbeek RDA, Nicolaas L, Rijnberg WJ, van Loon CJM, van Kampen A. Correction accuracy and collateral laxity in open versus closed wedge high tibial osteotomy. A one-year randomised controlled study. Int Orthop. 2010;34:201–7.

    PubMed  Google Scholar 

  24. Verschueren J, et al. Possibility of quantitative T2-mapping MRI of cartilage near metal in high tibial osteotomy: a human cadaver study. J Orthop Res. 2018;36:1206–12.

    PubMed  Google Scholar 

  25. Gersing AS, et al. Longitudinal changes in subchondral bone structure as assessed with MRI are associated with functional outcome after high tibial osteotomy. J ISAKOS. 2018;3:205–12.

    PubMed  PubMed Central  Google Scholar 

  26. Kumagai K, et al. Factors affecting cartilage repair after medial opening-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2017;25:779–84.

    PubMed  Google Scholar 

  27. Kim K-I, et al. Change of chondral lesions and predictive factors after medial open-wedge high tibial osteotomy with a locked plate system. Am J Sports Med. 2017;45:1615–21.

    PubMed  Google Scholar 

  28. Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. The Install Award. Survivorship of the high tibial valgus osteotomy. A 10- to 22-year followup study. Clin Orthop Relat Res. 1999;(367):18–27.

    Google Scholar 

  29. Duivenvoorden T, et al. Adverse events and survival after closing- and opening-wedge high tibial osteotomy: a comparative study of 412 patients. Knee Surg Sports Traumatol Arthrosc. 2017;25:895–901.

    CAS  PubMed  Google Scholar 

  30. Konopka JF, Gomoll AH, Thornhill TS, Katz JN, Losina E. The cost-effectiveness of surgical treatment of medial unicompartmental knee osteoarthritis in younger patients: a computer model-based evaluation. J Bone Joint Surg Am. 2015;97:807–17.

    PubMed  PubMed Central  Google Scholar 

  31. Saragaglia D, et al. Computer-assisted total knee replacement after medial opening wedge high tibial osteotomy: medium-term results in a series of ninety cases. Int Orthop. 2016;40:35–40.

    PubMed  Google Scholar 

  32. Han JH, et al. Total knee arthroplasty after failed high tibial osteotomy: a systematic review of open versus closed wedge osteotomy. Knee Surg Sports Traumatol Arthrosc. 2016;24:2567–77.

    PubMed  Google Scholar 

  33. Pearse AJ, Hooper GJ, Rothwell AG, Frampton C. Osteotomy and unicompartmental knee arthroplasty converted to total knee arthroplasty: data from the New Zealand Joint Registry. J Arthroplast. 2012;27:1827–31.

    Google Scholar 

  34. Kuwashima U, et al. Comparison of the impact of closing wedge versus opening wedge high tibial osteotomy on proximal tibial deformity and subsequent revision to total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25:869–75.

    PubMed  Google Scholar 

  35. Ehlinger M, et al. Total knee arthroplasty after opening- versus closing-wedge high tibial osteotomy. A 135-case series with minimum 5-year follow-up. Orthop Traumatol Surg Res. 2017;103:1035–9.

    CAS  PubMed  Google Scholar 

  36. Rand J, Neyret P. ISAKOS meeting on the management of osteoarthritis of the knee prior to total knee arthroplasty. 2005.

    Google Scholar 

  37. Bonasia DE, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors. Am J Sports Med. 2014;42:690–8.

    PubMed  Google Scholar 

  38. Han S-B, et al. Complications associated with medial opening-wedge high tibial osteotomy using a locking plate: a multicenter study. J Arthroplast. 2018; https://doi.org/10.1016/j.arth.2018.11.009.

  39. Woodacre T, et al. Complications associated with opening wedge high tibial osteotomy—a review of the literature and of 15 years of experience. Knee. 2016;23:276–82.

    CAS  PubMed  Google Scholar 

  40. Nerhus TK, et al. No difference in time-dependent improvement in functional outcome following closing wedge versus opening wedge high tibial osteotomy: a randomised controlled trial with two-year follow-up. Bone Joint J. 2017;99-B:1157–66.

    CAS  PubMed  Google Scholar 

  41. van Egmond N, van Grinsven S, van Loon CJM, Gaasbeek RD, van Kampen A. Better clinical results after closed- compared to open-wedge high tibial osteotomy in patients with medial knee osteoarthritis and varus leg alignment. Knee Surg Sports Traumatol Arthrosc. 2016;24:34–41.

    PubMed  Google Scholar 

  42. Herman BV, Giffin JR. High tibial osteotomy in the ACL-deficient knee with medial compartment osteoarthritis. J Orthop Traumatol. 2016;17:277–85.

    PubMed  PubMed Central  Google Scholar 

  43. Ranawat AS, et al. Comparison of lateral closing-wedge versus medial opening-wedge high tibial osteotomy on knee joint alignment and kinematics in the ACL-deficient knee. Am J Sports Med. 2016;44:3103–10.

    PubMed  Google Scholar 

  44. Tanaka T, et al. Deterioration of patellofemoral cartilage status after medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2018; https://doi.org/10.1007/s00167-018-5128-7.

  45. Cooke D, et al. Axial lower-limb alignment: comparison of knee geometry in normal volunteers and osteoarthritis patients. Osteoarthr Cartil. 1997;5:39–47.

    CAS  PubMed  Google Scholar 

  46. Matsumoto T, et al. A radiographic analysis of alignment of the lower extremities—initiation and progression of varus-type knee osteoarthritis. Osteoarthr Cartil. 2015;23:217–23.

    CAS  PubMed  Google Scholar 

  47. Nakamura R, Kuroda K, Takahashi M, Katsuki Y. Additional distal femoral osteotomy for insufficient correction after high tibial osteotomy. BMJ Case Rep. 2018;2018:bcr2018224514.

    PubMed Central  Google Scholar 

  48. Yang ZY, et al. Medial compartment decompression by fibular osteotomy to treat medial compartment knee osteoarthritis: a pilot study. Orthopedics. 2015;38:e1110–4.

    PubMed  Google Scholar 

  49. Baldini T, et al. Medial compartment decompression by proximal fibular osteotomy: a biomechanical cadaver study. Orthopedics. 2018;41:e496–501.

    PubMed  Google Scholar 

  50. Liu B, et al. Proximal fibular osteotomy to treat medial compartment knee osteoarthritis: preoperational factors for short-term prognosis. PLoS One. 2018;13:e0197980.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Avon Orthopaedic Centre, Bristol, UK

    Sven Putnis

  2. Sydney Orthopaedic Research Institute, Sydney, NSW, Australia

    Sven Putnis, Thomas Neri & David Parker

  3. University hospital of Saint-Etienne, Saint-Priest-en-Jarez, France

    Thomas Neri

Authors
  1. Sven Putnis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Neri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Orthopaedic Surgery Department, University College London Hospitals, London, UK

    Sam Oussedik

  2. Orthopaedic Surgery, Arthritis and Joint Replacement Department, Lyon Croix-Rousse Univeristy Hospital, Lyon, France

    Sebastien Lustig

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Putnis, S., Neri, T., Parker, D. (2020). Outcomes of Surgery for Medial Arthrosis. In: Oussedik, S., Lustig, S. (eds) Osteotomy About the Knee . Springer, Cham. https://doi.org/10.1007/978-3-030-49055-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-49055-3_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-49054-6

  • Online ISBN: 978-3-030-49055-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation