Joint preservation procedures: osteotomies about the knee.

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Abstract

Conflict of interest statement: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aoj.amegroups.com/article/view/10.21037/aoj-24-68/coif). The series “Current Concepts and Techniques in Soft Tissue Repair and Joint Preservation” was commissioned by the editorial office without any funding or sponsorship. J.D.H. serves as an unpaid editorial board member of Annals of Joint from July 2024 to December 2026. J.D.H. reports that he serves as a paid consultant for Smith and Nephew and is a member of the editorial board of the journal Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA). The authors have no other conflicts of interest to declare. 8. Orthop Surg. 2021 Jul;13(5):1465-1473. doi: 10.1111/os.13021. Epub 2021 Jun 10. Osteotomy Around the Knee: The Surgical Treatment of Osteoarthritis. Peng H(1), Ou A(2), Huang X(3), Wang C(1), Wang L(1), Yu T(1)(4), Zhang Y(5)(6), Zhang Y(1)(4)(7). Author information: (1)Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao, China. (2)Department of Operating Room, Affiliated Hospital of Qingdao University, Qingdao, China. (3)Institute of Neuroregeneration and Neurorehabilitation, Qingdao University, Qingdao, China. (4)Institute of Sports Medicine and Rehabilitation, Qingdao University, Qingdao, China. (5)Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China. (6)Department of Orthopedics, Affiliated Hospital of Qingdao University, Qingdao, China. (7)Shandong Institute of Traumatic Orthopedics, Affiliated Hospital of Qingdao University, Qingdao, China. Osteoarthritis causes joint pain and functional disorder, of which knee osteoarthritis is the most common. Nowadays, clinically effective treatments mainly include conservative treatment, arthroplasty, and osteotomy. However, conservative treatment only offers symptomatic relief and arthroplasty is limited to the patients with a moderate to severe degree of osteoarthritis. For relatively young patients who require greater knee preservation, a surgical treatment with low operation trauma and revision rate is needed. Osteotomy around the knee, based on the notion of "knee preservation," has been chosen as an alternative surgical treatment. Cutting and realigning the bones corrects the mechanical line of lower limb force bearing. As such, osteotomy around the knee retains normal anatomical structure and obtains good functional recovery of the knee joint. The techniques of osteotomy around the knee includes anti-varus deformity and anti-valgus deformity osteotomy, aiming to reallocate the force bearing in the compartment of the knee joint. By choosing the surgical section of the lower limbs, the osteotomy around the knee can achieve the correction of mechanical axis, such as the high tibial osteotomy (HTO), proximal fibular osteotomy (PFO), and distal femur osteotomy (DFO). Numerous modified techniques have been developed to meet the demands of patients based on traditional methods. These modified osteotomy have their own advantages and indications. This paper aims to guide clinical treatment by reviewing different types of osteotomies, and their effects, that have been studied and applied widely in clinical practices. © 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. DOI: 10.1111/os.13021 PMCID: PMC8313165