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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; Brian J Cole, MD, MBA; 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, non-arthroplasty strategies aimed at joint preservation are necessary. Regardless of the ligamentous and cartilaginous integrity of the knee, patients with malalignment may be predisposed to the premature development of symptomatic arthritis. Historically, procedures intended for correction of the malaligned knee, including high tibial osteotomy (HTO) and distal femoral osteotomy (DFO), have been utilized in young laborers with painful knees. As techniques and implants improve, the indications for osteotomy are evolving to be utilized either as an adjunct to cartilage/ligament reconstructive procedures, or as an isolated joint preservation strategy. The purposes of this video are to describe the surgical management of patients with symptomatic malalignment treated effectively with either HTO or DFO, with or without concomitant cartilage/meniscal restoration procedures.

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