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Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?

Malalignment of the knee can cause debilitating symptoms such as pain, resulting in a decline in function and mobility. Surgical options that exist to address this problem include realignment osteotomies and joint replacements. Realignment osteotomies are the more appropriate options in certain pati...

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Autores principales: Thambiah, Matthew Dhanaraj, Tan, Melvin K L, Hui, James H P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609380/
https://www.ncbi.nlm.nih.gov/pubmed/28966382
http://dx.doi.org/10.4103/ortho.IJOrtho_260_17
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author Thambiah, Matthew Dhanaraj
Tan, Melvin K L
Hui, James H P
author_facet Thambiah, Matthew Dhanaraj
Tan, Melvin K L
Hui, James H P
author_sort Thambiah, Matthew Dhanaraj
collection PubMed
description Malalignment of the knee can cause debilitating symptoms such as pain, resulting in a decline in function and mobility. Surgical options that exist to address this problem include realignment osteotomies and joint replacements. Realignment osteotomies are the more appropriate options in certain patient populations, especially with regard to age and level of activity. Since a high tibial osteotomy (HTO) was first used to manage malalignment of the knee and osteoarthritis, different techniques involving the use of specialized implants have been developed and further refined to good effect. There has also since been much research into the field of cartilage restoration techniques, both as a standalone treatment option and as an adjunct to a realignment osteotomy. This review attempts to detail the origin and the evolution of HTO, particularly in regard to combining this tried and tested procedure with adjunct cartilage restoration techniques, and the overall patient outcomes. A literature search on PubMed was performed, and articles pertaining to the outcomes of the use of an HTO and cartilage restoration techniques were reviewed. The literature in this field indicates good outcomes in terms of objective measurements of cartilage regeneration (such as arthroscopic visualization and magnetic resonance imaging evaluation) and subjective patient outcome scoring systems (such as the International Knee Documentation Committee and Lysholm scores) with a realignment osteotomy alone, and studies have shown that patient outcomes can be further improved with the use of a cartilage restoration procedure as an adjunct.
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spelling pubmed-56093802017-09-29 Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success? Thambiah, Matthew Dhanaraj Tan, Melvin K L Hui, James H P Indian J Orthop Symposium - Sports Injury Malalignment of the knee can cause debilitating symptoms such as pain, resulting in a decline in function and mobility. Surgical options that exist to address this problem include realignment osteotomies and joint replacements. Realignment osteotomies are the more appropriate options in certain patient populations, especially with regard to age and level of activity. Since a high tibial osteotomy (HTO) was first used to manage malalignment of the knee and osteoarthritis, different techniques involving the use of specialized implants have been developed and further refined to good effect. There has also since been much research into the field of cartilage restoration techniques, both as a standalone treatment option and as an adjunct to a realignment osteotomy. This review attempts to detail the origin and the evolution of HTO, particularly in regard to combining this tried and tested procedure with adjunct cartilage restoration techniques, and the overall patient outcomes. A literature search on PubMed was performed, and articles pertaining to the outcomes of the use of an HTO and cartilage restoration techniques were reviewed. The literature in this field indicates good outcomes in terms of objective measurements of cartilage regeneration (such as arthroscopic visualization and magnetic resonance imaging evaluation) and subjective patient outcome scoring systems (such as the International Knee Documentation Committee and Lysholm scores) with a realignment osteotomy alone, and studies have shown that patient outcomes can be further improved with the use of a cartilage restoration procedure as an adjunct. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5609380/ /pubmed/28966382 http://dx.doi.org/10.4103/ortho.IJOrtho_260_17 Text en Copyright: © 2017 Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Symposium - Sports Injury
Thambiah, Matthew Dhanaraj
Tan, Melvin K L
Hui, James H P
Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?
title Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?
title_full Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?
title_fullStr Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?
title_full_unstemmed Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?
title_short Role of High Tibial Osteotomy in Cartilage Regeneration – Is Correction of Malalignment Mandatory for Success?
title_sort role of high tibial osteotomy in cartilage regeneration – is correction of malalignment mandatory for success?
topic Symposium - Sports Injury
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609380/
https://www.ncbi.nlm.nih.gov/pubmed/28966382
http://dx.doi.org/10.4103/ortho.IJOrtho_260_17
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