opening wedge

Aetiology

Trauma

RA

Rickets / osteomalacia

Issues

Horizontal joint line important

- < 10° tilt acceptable

> 10^o joint line tilt / due to femoral valgus

- continues to overload lateral compartment

Position

- patient supine on radiolucent table

- place ECG lead and artery clip over centre of femoral head

- useful to put II ipsilateral to leg, and place knee on cassette

Aetiology Unicompartmental 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 

Definition

Progressive varus deformity of knees

- secondary to abnormality of medial upper tibial physis

- localised varus & internal rotation deformity

Infantile form 

- onset 1-3 years / bilateral

Adolescent form