Osteotomy Around the Knee: The Surgical Treatment of Osteoarthritis.

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Abstract

[Indexed for MEDLINE] 2. AJR Am J Roentgenol. 2022 Apr;218(4):701-712. doi: 10.2214/AJR.21.26659. Epub 2021 Nov 24. High Tibial Osteotomy: An Update for Radiologists. Li OL(1), Pritchett S(1), Giffin JR(2), Spouge ARI(1). Author information: (1)Department of Medical Imaging, Musculoskeletal Division, Schulich School of Medicine of Western University, University Hospital, London Health Sciences Centre, 339 Windermere Rd, London, ON N6A 5A5, Canada. (2)Fowler Kennedy Sport Medicine Clinic and Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Comment in AJR Am J Roentgenol. 2022 Apr;218(4):713. doi: 10.2214/AJR.21.27143. High tibial osteotomy (HTO) is a surgical procedure to treat symptomatic unicompartmental osteoarthritis (OA) associated with knee malalignment. There has been a recent resurgence of interest in HTO in patients who prefer joint-preserving surgery because HTO shifts the knee's mechanical axis from the arthritic compartment to a neutral position, thereby reducing knee pain, slowing progression of OA, and delaying the need for a total knee arthroplasty. The ideal candidates for HTO are patients who are young, active, and nonobese who have isolated varus deformity of the knee resulting from medial compartment OA. Radiography is critical in the preoperative evaluation for HTO and can help expand surgical indications to include a wider variety of patients. Radiography is also routinely obtained in postoperative assessment and is typically the first test to indicate complications. This review describes the radiologic aspects of HTO, including preoperative imaging assessment and normal and abnormal postoperative imaging appearances. Surgical techniques and osteotomy fixation devices are described, with a focus on the medial opening wedge approach. Given the growing interest in HTO, radiologists should become familiar with the basics of the procedure and the role of imaging in preoperative and postoperative evaluation. DOI: 10.2214/AJR.21.26659