high tibial osteotomy

Complications

Undercorrection /  loss of correction 

 

Most important factor in good results and duration of results

- must correct to 8o of valgus

- mechanical axis must pass through lateral joint line

 

HTO Insufficient Correction

 

Causes

- inadequate initial correction

Background

Aetiology Unicompartmental OAKnee Medial Compartment OA

 

Trauma

Meniscectomy

Osteonecrosis

Varus or valgus malalignment

 

Goals of Osteotomy

 

Relief of pain

Improve function

No loss of ROM

No or slight restriction of activity

Allow heavy functional demands 

 

Chronic PLC Management

Issues

 

Limb alignment

 

Risk that late posterolateral corner reconstruction will fail in the setting of the varus knee

- varus knee alignment and varus thrust in stance phase

- consider osteotomy first in this setting

 

Results

 

Posterolateral Corner Reconstruction

 

Moulton et al. Am J Sports Med 2016

- systematic review of PCL reconstruction for chronic injuries

- 450 patients