IC 09-2026-Tools and Techniques of Osteotomies Around the Knee: A Practical How-To Guide-IC 09-2026-Tools and Techniques of Osteotomies Around the Knee: A Practical How-To Guide

Video Transcription

Video Summary

This session was a practical, video-based guide to osteotomies around the knee, focused on real-world tips, indications, planning, and pitfalls rather than literature review. The speakers emphasized that osteotomies are powerful joint-preservation tools that can correct alignment, improve biomechanics, and even influence joint biology.<br /><br />Key themes included patient selection, deformity localization, and choosing the right procedure for the pathology. Ideal candidates were described as “young patients with old knees,” while poor candidates include those with uncontrolled diabetes, smoking, osteoporosis, vascular disease, poor motion, severe multicompartment disease, or inability to follow rehab. Imaging and planning basics were reviewed: long-leg alignment films, MRI, selective CT, and measurements such as MPTA, mLDFA, posterior tibial slope, patellar height, TTTG, and rotational profile.<br /><br />Omar Pratsouk reviewed indications and a clinic-to-OR algorithm, stressing that symptoms must match the compartment being unloaded, the deformity source must be identified, and combined pathology must be addressed.<br /><br />Laith Jasravi focused on DFOs and HTOs, highlighting the rise of patient-specific instrumentation (PSI), which improves accuracy, reduces fluoroscopy, and makes complex or combined procedures easier. He also discussed when to consider double-level osteotomies to avoid excessive joint-line obliquity.<br /><br />Andreas Gomahl covered slope-changing osteotomies and tibial tubercle osteotomy (TTO), favoring infra-tubercular slope correction for safety and future revision flexibility. He also reviewed distalization TTO technique and emphasized careful protection of the hinge and neurovascular structures.<br /><br />The final discussion addressed combined procedures, the importance of sequencing, rehab planning, DVT prophylaxis, and learning curves. The speakers concluded that osteotomies are here to stay, especially with PSI, and encouraged surgeons to understand the anatomy, plan carefully, and not fear complex alignment correction.

Keywords

knee osteotomy

joint preservation

alignment correction

patient selection

deformity planning

high tibial osteotomy

distal femoral osteotomy

patient-specific instrumentation

tibial tubercle osteotomy

posterior tibial slope