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Knee Preservation With Osteotomy: Surgical Technique

February 19, 2016

Contributors: Nikhil N Verma, MD; Bernard R Bach Jr, MD; Charles A Bush-Joseph, MD; Adam Blair Yanke, MD, PhD, FAAOS; Brian J Cole, MD, MBA, FAAOS; Rachel M Frank, MD; Rachel M Frank, MD

The management of symptomatic malalignment in young, active patients is extremely challenging. With a demanding patient population that desires to remain active at younger ages, nonarthroplasty strategies are necessary for joint preservation. Regardless of the ligamentous and cartilaginous integrity of the knee, patients with malalignment may be predisposed to premature symptomatic arthritis. Historically, procedures for the correction of a malaligned knee, including high tibial osteotomy and distal femoral osteotomy, were used in young laborers with painful knees. The indications for osteotomy are evolving as techniques and implants improve, allowing the procedure to be performed as an adjunct to cartilage/ligament reconstruction or as an isolated joint preservation strategy. This video describes the surgical treatment of patients with symptomatic malalignment via high tibial osteotomy or distal femoral osteotomy with or without concomitant cartilage/meniscal restoration procedures.

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