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Archive for the ‘Osteotomy’ Category

Osteotomy

Osteotomy

This blog post is part of a series about the Academy of Orthopedic Surgeons’ (AAOS) Full Treatment Guideline for Knee Osteoarthritis.

Recommendation 20 – The AAOS cannot recommend for or against an osteotomy of the tibial tubercle for patients with patello-femoral osteoarthritis.

No studies were available that investigated taking bone wedges from the tibial tubercle for patients with isolated patello-femoral osteoarthritis.  So the research team was unable to reach a definitive conclusion.



This is a continuation of our series on the Osteoarthritis Research Society International (OARSI) recommendations for the management of hip and knee osteoarthritis published in the Journal of Osteoarthritis and Cartilage.

tibial osteotomy

tibial osteotomy

Recommendation XXIII

Patients with significant symptoms from unicompartmental knee osteoarthritis may benefit from a high tibial osteotomy.

Ten out of ten existing guidelines recommend osteotomy as a treatment option.  High tibial osteotomies came into fashion during the 1960’s.  19 uncontrolled cohort studies examined 2406 osteotomies.  Good or excellent outcomes were achieved in 75% of the patients.  The overall failure rate at 10 years was 25%.

The research team gave this osteoarthritis treatment option a Strength of Recommendation score of 75%.

W. Zhang Ph.D., Moskowitz M.D., et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage. (2008) 16, 137-162