High Tibial Osteotomy: State of the art
Keywords
High tibial osteotomy
osteoarthritis
knee
Abstract
The number of cases handled by PJI is projected to rise in the coming years. The diagnosis of PJI relies on evaluating microbiology, inflammatory response, and pathology. However, the accuracy of the diagnosis is compromised by previous exposure to antimicrobial agents, the possibility of contamination, and the lack of specificity of inflammatory markers. Although new testing methods, such as molecular techniques, hold the potential for a swift diagnosis, they are constrained by the risk of contamination and the absence of susceptibility results. Interestingly, emerging synovial fluid markers exhibit promise as an additional tool in diagnosing PJI. The management of each PJI case, both in terms of surgery and antimicrobial treatment, requires an individualized assessment. It is imperative to conduct high-quality studies that aim to determine the most effective route and duration of antimicrobial treatment for each surgical approach. This review provides an overview of the diagnostic tests and treatment options for prosthetic joint infection, offering a practical approach to managing this complex clinical condition.
References
- Di Matteo B, Tarabella V, Filardo G, Viganò A, Tomba P, Marcacci M. John Rhea Barton: The birth of osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy. 2013;21(9):1957-1962. doi:10.1007/s00167-013-2387-1
- Sabzevari S, Ebrahimpour A, Mostafa ;, Roudi K, Kachooei AR. High Tibial Osteotomy: A Systematic Review and Current Concept. Vol 4.; 2016. http://abjs.mums.ac.irtheonlineversionofthisarticleabjs.mums.ac.ir
- Lee DC, Byun SJ. High tibial osteotomy. Knee Surg Relat Res. 2012;24(2):61-69. doi:10.5792/ksrr.2012.24.2.61
- Smith JO, Wilson AJ, Thomas NP. Osteotomy around the knee: Evolution, principles and results. Knee Surgery, Sports Traumatology, Arthroscopy. 2013;21(1):3-22. doi:10.1007/s00167-012-2206-0
- Krych AJ, Hevesi M, Desai VS, Camp CL, Stuart MJ, Saris DBF. Learning From Failure in Cartilage Repair Surgery: An Analysis of the Mode of Failure of Primary Procedures in Consecutive Cases at a Tertiary Referral Center. Orthop J Sports Med. 2018;6(5). doi:10.1177/2325967118773041
- Dean CS, Liechti DJ, Chahla J, Moatshe G, LaPrade RF. Clinical Outcomes of High Tibial Osteotomy for Knee Instability: A Systematic Review. Orthop J Sports Med. 2016;4(3). doi:10.1177/2325967116633419
- Brinkman JM, Lobenhoffer P, Agneskirchner JD, et al. Osteotomies around the knee PATIENT SELECTION, STABILITY OF FIXATION AND BONE HEALING IN HIGH TIBIAL OSTEOTOMIES. J Bone Joint Surg. doi:10.1302/0301-620X.90B12
- Santoso MB, Wu L. Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review. J Orthop Surg Res. 2017;12(1). doi:10.1186/s13018-017-0552-9
- Goodell PB, Johansen PM, Bartels DW, Sherman SL, Amanatullah DF. Comparing Unicompartmental Knee Arthroplasty and High Tibial Osteotomy for Isolated Medial Compartment Knee Osteoarthritis. JBJS Rev. 2023;11(3). doi:10.2106/JBJS.RVW.22.00127
- Gademan MGJ, Hofstede SN, Vliet Vlieland TPM, Nelissen RGHH, Marang-Van de Mheen PJ. Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview. BMC Musculoskelet Disord. 2016;17(1):1-11. doi:10.1186/s12891-016-1325-z
- Adie S, Harris I, Chuan A, Lewis P, Naylor JM. St George Hospital, Sydney, NSW. 3 South Western Sydney Clinical School. (2). doi:10.5694/mja2.12109â–ªPublished
- Liu X, Chen Z, Gao Y, Zhang J, Jin Z. High Tibial Osteotomy: Review of Techniques and Biomechanics. J Healthc Eng. 2019;2019. doi:10.1155/2019/8363128
- Thomas A, Round J. Basic principles of lower limb deformity correction. Surgery (Oxford). 2023;41(4):255-261. doi:10.1016/J.MPSUR.2023.02.015
- LuÃs NM, Varatojo R. Radiological assessment of lower limb alignment. EFORT Open Rev. 2021;6(6):487-494. doi:10.1302/2058-5241.6.210015
- Deakin AH, Basanagoudar PL, Nunag P, Johnston AT, Sarungi M. Natural distribution of the femoral mechanical–anatomical angle in an osteoarthritic population and its relevance to total knee arthroplasty. Knee. 2012;19(2):120-123. doi:10.1016/J.KNEE.2011.02.001
- Lobenhoffer P, van Heerwarden R, Staubli A, Jakob R. Osteotomies around the Knee, Indication-Planning-Surgical Techniques Using Plate Fixators. (Lobenhoffer PP, van Heerwaarden RJ, Staubli AE, Jakob RP, Galla M, Agneskirchner JD, eds.). Georg Thieme Verlag; 2013. doi:10.1055/b-0034-9881
- Wolcott M, Traub S, Efird C. High tibial osteotomies in the young active patient. Int Orthop. 2010;34(2 SPECIAL ISSUE):161-166. doi:10.1007/s00264-009-0944-5
- Bentley G, ed. European Surgical Orthopaedics and Traumatology : The EFORT Textbook. Springer Reference; 2014.
- Savarese E, Bisicchia S, Romeo R, Amendola A. Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner. Journal of Orthopaedics and Traumatology. 2011;12(1):1-17. doi:10.1007/s10195-010-0120-0
- Khakha RS, Bin Abd Razak HR, Kley K, van Heerwaarden R, Wilson AJ. Role of high tibial osteotomy in medial compartment osteoarthritis of the knee: Indications, surgical technique and outcomes. J Clin Orthop Trauma. 2021;23. doi:10.1016/j.jcot.2021.101618
- 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(3):585-608.
- Kang BY, Lee DK, Kim HS, Wang JH. How to achieve an optimal alignment in medial opening wedge high tibial osteotomy? Knee Surg Relat Res. 2022;34(1). doi:10.1186/s43019-021-00130-2
- Kolb W, Guhlmann H, Windisch C, Kolb K. High Tibial Open-Wedge Osteotomy-New Techniques and Early Results. www.intechopen.com
- Atkinson HF, Birmingham TB, Schulz JM, et al. High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition. Knee Surgery, Sports Traumatology, Arthroscopy. 2022;30(3):1065-1074. doi:10.1007/s00167-021-06516-9
- Kim MK, Ko BS, Park JH. The proper correction of the mechanical axis in high tibial osteotomy with concomitant cartilage procedures - A retrospective comparative study. J Orthop Surg Res. 2019;14(1). doi:10.1186/s13018-019-1333-4
- Pape D, Rupp S. Preoperative Planning for High Tibial Osteotomies. Oper Tech Orthop. 2007;17(1):2-11. doi:10.1053/j.oto.2006.09.007
- Cofaru NF, Roman MD, Cofaru II, Oleksik VS, Fleaca SR. Medial opening wedge high tibial osteotomy in knee osteoarthritis—a biomechanical approach. Applied Sciences (Switzerland). 2020;10(24):1-20. doi:10.3390/app10248972
- Lee YS, Kim MG, Byun HW, Kim SB, Kim JG. Reliability of the imaging software in the preoperative planning of the open-wedge high tibial osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy. 2015;23(3):846-851. doi:10.1007/s00167-013-2700-z
- Sivertsen EA, Vik J, Meland ASV, Nerhus TK. The Dugdale planning method for high tibial osteotomies underestimates the correction angle compared to the Miniaci method. Knee Surgery, Sports Traumatology, Arthroscopy. 2023;31(4):1507-1514. doi:10.1007/s00167-021-06663-z
- Yoon SD, Zhang G, Kim HJ, Lee BJ, Kyung HS. Comparison of cable method and miniaci method using picture archiving and communication system in preoperative planning for open wedge high tibial osteotomy. Knee Surg Relat Res. 2016;28(4):283-288. doi:10.5792/ksrr.16.052
- Guy S, Khakha R, Ollivier M. Anterior Closing-Wedge High Tibial Osteotomy Using Patient-Specific Cutting Guide in Chronic Anterior Cruciate Ligament–Deficient Knees. Arthrosc Tech. 2022;11(9):e1605-e1612. doi:10.1016/j.eats.2022.05.006
- Dragosloveanu S, Cristea S, Dragosloveanu C, Street B. Maedica-a Journal of Clinical Medicine The Effect of High Tibial Osteotomy on the Posterior Tibial Slope. Vol 9.; 2014.
- Lee DC, Byun SJ. High tibial osteotomy. Knee Surg Relat Res. 2012;24(2):61-69. doi:10.5792/ksrr.2012.24.2.61
- Ruzbarsky JJ, Arner JW, Dornan GJ, Provencher MT, Vidal AF. Tibial Slope Can Be Maintained During Medial Opening-Wedge Proximal Tibial Osteotomy With Sagittally Oriented Hinge, Posterior Plate Position, and Knee Hyperextension: A Cadaveric Study. Arthroscopy - Journal of Arthroscopic and Related Surgery. 2021;37(7):2181-2188. doi:10.1016/j.arthro.2021.01.065
- Ogawa H, Matsumoto K, Ogawa T, Takeuchi K, Akiyama H. Effect of Wedge Insertion Angle on Posterior Tibial Slope in Medial Opening Wedge High Tibial Osteotomy. Orthop J Sports Med. 2016;4(2). doi:10.1177/2325967116630748
- Bin S Il, Kim HJ, Ahn HS, Rim DS, Lee DH. Changes in Patellar Height After Opening Wedge and Closing Wedge High Tibial Osteotomy: A Meta-analysis. Arthroscopy - Journal of Arthroscopic and Related Surgery. 2016;32(11):2393-2400. doi:10.1016/j.arthro.2016.06.012
- Kim HJ, Shin JY, Lee HJ, Park KH, Jung CH, Kyung HS. The patellofemoral joint does not deteriorate clinically after open-wedge high tibial osteotomy. Orthopaedics and Traumatology: Surgery and Research. 2021;107(4). doi:10.1016/j.otsr.2021.102907
- Huizinga MR, Brouwer RW, Van Raaij TM. High tibial osteotomy: Closed wedge versus combined wedge osteotomy. BMC Musculoskelet Disord. 2014;15(1). doi:10.1186/1471-2474-15-124
- Marcheggiani Muccioli GM, Fratini S, Cammisa E, et al. Lateral Closing Wedge High Tibial Osteotomy for Medial Compartment Arthrosis or Overload. Clin Sports Med. 2019;38(3):375-386. doi:10.1016/j.csm.2019.02.002
- Ferner F, Lutter C, Dickschas J, Strecker W. Medial open wedge vs. lateral closed wedge high tibial osteotomy - Indications based on the findings of patellar height, leg length, torsional correction and clinical outcome in one hundred cases. Int Orthop. 2019;43(6):1379-1386. doi:10.1007/s00264-018-4155-9
- Gaasbeek RDA, Sonneveld H, Van Heerwaarden RJ, Jacobs WCH, Wymenga AB. Distal tuberosity osteotomy in open wedge high tibial osteotomy can prevent patella infera: A new technique. Knee. 2004;11(6):457-461. doi:10.1016/j.knee.2004.02.002
- Gaasbeek RDA, Sonneveld H, Van Heerwaarden RJ, Jacobs WCH, Wymenga AB. Distal tuberosity osteotomy in open wedge high tibial osteotomy can prevent patella infera: A new technique. Knee. 2004;11(6):457-461. doi:10.1016/j.knee.2004.02.002
- Akiyama T, Osano K, Mizu-Uchi H, et al. Distal Tibial Tuberosity Arc Osteotomy in Open-Wedge Proximal Tibial Osteotomy to Prevent Patella Infra. Arthrosc Tech. 2019;8(6):e655-e662. doi:10.1016/j.eats.2019.02.011
- Peng H, Ou A, Huang X, et al. Osteotomy Around the Knee: The Surgical Treatment of Osteoarthritis. Orthop Surg. 2021;13(5):1465-1473. doi:10.1111/os.13021
- Schröter S, Nakayama H, Yoshiya S, Stöckle U, Ateschrang A, Gruhn J. Development of the double level osteotomy in severe varus osteoarthritis showed good outcome by preventing oblique joint line. Arch Orthop Trauma Surg. 2019;139(4):519-527. doi:10.1007/s00402-018-3068-9
- Iseki T, Onishi S, Kanto M, et al. Double-level osteotomy for severe varus osteoarthritic knees can prevent change in leg length and restore physiological joint geometry. Knee. 2021;31:136-143. doi:10.1016/j.knee.2021.04.011
- Saito H, Yonekura A, Saito K, et al. A new double level osteotomy procedure to restore a joint line and joint angles in severe varus osteoarthritis. - Double level osteotomy associated with tibial condylar valgus osteotomy (DLOTO) -. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2021;24:9-13. doi:10.1016/j.asmart.2020.11.001
- Elbardesy H, McLeod A, Ghaith HS, Hakeem S, Housden P. Outcomes of double level osteotomy for osteoarthritic knees with severe varus deformity. A systematic review. SICOT J. 2022;8. doi:10.1051/sicotj/2022009
- Coakley A, McNicholas M, Biant L, Tawy G. A systematic review of outcomes of high tibial osteotomy for the valgus knee. Knee. 2023;40:97-110. doi:10.1016/j.knee.2022.11.007
- Müller M, Strecker W. Arthroscopy prior to osteotomy around the knee? Arch Orthop Trauma Surg. 2008;128(11):1217-1221. doi:10.1007/s00402-007-0398-4
- Rozkydal Z, Kura V, Ondrusek S. The arthroscopic debridement in the management of osteoarthritis of the knee joint by high tibial osteotomy. Bratisl Lek Listy. 2003;104(11):362-366.
- Friemert B, Oberländer Y, Danz B, et al. MRT versus Arthroskopie Bei Der Diagnostik von Chondralen Läsionen Des Kniegelenkes. Kann Die MRT Die Arthroskopie Ersetzen? Eine Prospektive Studie.
- Ferruzzi A, Buda R, Cavallo M, Timoncini A, Natali S, Giannini S. Cartilage repair procedures associated with high tibial osteotomy in varus knees: Clinical results at 11years’ follow-up. Knee. 2014;21(2):445-450. doi:10.1016/j.knee.2013.11.013
- Wu J, Zhao B, Luo W, et al. Arthroscopy combined with high tibial osteotomy promotes cartilage regeneration in osteoarthritis. Journal of Orthopaedic Surgery. 2023;31(1). doi:10.1177/10225536231165357
- Zhao B, Xiao Q, Liu B. Effects of High Tibial Osteotomy Combined with Arthroscopy on Pain and Inflammation Markers in Patients with Medial Knee Osteoarthritis. Journal of Investigative Surgery. 2022;35(4):891-897. doi:10.1080/08941939.2021.1931576
- Ding T, Tan Y, Tian X, et al. Patellar Height after High Tibial Osteotomy of the Distal Tibial Tuberosity: A Retrospective Study of Age Stratification. Comput Math Methods Med. 2022;2022. doi:10.1155/2022/7193902
- Gooi S, Chan C, Tan M, Lim A, Satkunanantham K, Hui J. Patella height changes post high tibial osteotomy. Indian J Orthop. 2017;51(5):545-551. doi:10.4103/ortho.IJOrtho_214_17
- Ren YM, Tian MQ, Duan YH, Sun YB, Yang T, Hou WY. Distal tibial tubercle osteotomy can lessen change in patellar height post medial opening wedge high tibial osteotomy? A systematic review and meta-analysis. J Orthop Surg Res. 2022;17(1). doi:10.1186/s13018-022-03231-0
- Nha KW, Kim HJ, Ahn HS, Lee DH. Change in Posterior Tibial Slope after Open-Wedge and Closed-Wedge High Tibial Osteotomy. American Journal of Sports Medicine. 2016;44(11):3006-3013. doi:10.1177/0363546515626172
- Iseki T, Onishi S, Kanto R, et al. Increased posterior slope and coronal inclination of the tibial joint line after opening wedge high tibial osteotomy may induce mucoid degeneration of the anterior cruciate ligament: A case report. Journal of ISAKOS. 2022;7(6):214-218. doi:10.1016/j.jisako.2022.08.006
- Kwon OJ, Kim JM, Bin S Il, Lee BS, Yoon GW, Kwon YH. Morphologic MRI changes of the anterior cruciate ligament are associated with an increase in the medial tibial plateau bony slope after medial opening wedge high tibial osteotomy in a non-injured ACL population. Orthopaedics and Traumatology: Surgery and Research. 2019;105(7):1369-1375. doi:10.1016/j.otsr.2019.08.005
- Ogawa H, Matsumoto K, Akiyama H. Effect of increased posterior tibial slope on the anterior cruciate ligament status in medial open wedge high tibial osteotomy in an uninjured ACL population. Orthopaedics and Traumatology: Surgery and Research. 2019;105(6):1085-1091. doi:10.1016/j.otsr.2019.05.003
- Aalderink KJ, Shaffer M, Amendola A. Rehabilitation Following High Tibial Osteotomy. Clin Sports Med. 2010;29(2):291-301. doi:10.1016/j.csm.2009.12.005
- Screpis D, Piovan G, Baldini M, et al. Higher activity level after opening wedge high tibial osteotomy compared to medial unicompartimental knee arthroplasty in a selected cohort of advanced age: A propensity score-matched analysis. Knee. 2023;40:183-191. doi:10.1016/j.knee.2022.11.006
- Kuwashima U. High tibial osteotomy: The past, present, and future. Journal of Joint Surgery and Research. 2023;1(1):103-107. doi:10.1016/j.jjoisr.2023.03.001
- Kumagai K, Fujimaki H, Yamada S, Nejima S, Matsubara J, Inaba Y. Changes of synovial fluid biomarker levels after opening wedge high tibial osteotomy in patients with knee osteoarthritis. Osteoarthritis Cartilage. 2021;29(7):1020-1028. doi:10.1016/j.joca.2021.03.013
- Kucirek NK, Anigwe C, Zhang AL, Ma CB, Feeley BT, Lansdown DA. Complications after high tibial osteotomy and distal femoral osteotomy are associated with increasing medical comorbidities and tobacco use. Knee Surgery, Sports Traumatology, Arthroscopy. 2022;30(12):4029-4045. doi:10.1007/s00167-022-06865-z
- Wei C, Xie W, Zhang W, et al. New insight into the current study of high tibial osteotomy: A bibliometric analysis. Medicine (United States). 2022;101(37):E30357. doi:10.1097/MD.0000000000030357