High tibial ostetotomy by CAS: method's presentation, results and critical evaluation

摘要

Introduction: In the last 50 years the high tibial osteotomy to correct a medial arthritis knee and deformity of lower extremity has been widely performed. Nevertheless the problem to achieve intraoperatively the planned correction of the knee axis , which heavily will impact on the outcome, has never been solved. [1,2,3] The mistakes are due to several items as the unreliability of the preoperative X-ray unproperly shot and the intricancy to evaluate the tibial rotation, which might lead the surgeon into a hyper or hypocorrection with a subsequent altered joint line obliquity. Altered joint obliquity can cause complications during a total knee replacement (TKR), requiring sometimes another osteotomy during TKR to correct the mal-union and avoid a severe ligamentous imbalance [3,4,6] Methods: In 2006, from July to October, 9 symptomatic varus knee deformities ( 3,6?10,5?, six females and three males, have been undergone to high tibial osteotomy by an open wedge technique; six of them were simple ostetomies and three of them underwent to ACL reconstruction by semitendinosus and gracilis tendon's graft.