IC 304-2022: Technical Tips and Tricks for Knee Osteotomy-Technical Tips and Tricks for Knee Osteotomy (4/5)

Video Transcription

Video Summary

In the video, the speaker discusses different factors to consider when choosing the appropriate osteotomy technique for patients with defects. Factors such as correction need, arthritis stage, ligamentous instability, leg length, weight, activity level, age, tibial femoral torsion, and surgery preference all play a role in the decision-making process. The speaker mentions a study showing that an IT osteotomy with the leg open results in a 7mm length increase, while a closed leg IT osteotomy reduces leg length by about 4mm. Additionally, the speaker emphasizes the importance of clinical examination, alignment assessment, gait observation, examination of the patellofemoral joint, stability check, and obtaining an MRI to assess cartilage and meniscus quality. The speaker shares their preference for closed leg IT osteotomy for angles less than 15 degrees of varus and open leg for treating high defects. They highlight the benefits of closed leg IT osteotomy, such as faster recovery and easier combination with additional procedures. The survival rate of closed leg IT osteotomy is reported to be good, with 80-90% positive results at 10 years and still good results at 15 years. Adverse events associated with closed leg IT osteotomy include peroneal nerve injury, proximal tibiofemoral disruptions, bone loss, and fracture of the cortical medial line. The speaker demonstrates their technique and emphasizes the importance of releasing the nerve and protecting the posterior tibialis anterior during the procedure.

Asset Caption

Stefano Zaffagnini, MD

Keywords

osteotomy technique

leg length

closed leg IT osteotomy

clinical examination

peroneal nerve injury