IC 304-2023: Technical Tips and Tricks for Knee Osteotomy-IC 304 - Technical Tips and Tricks for Knee Osteotomy (4/4)

Video Transcription

Video Summary

In the video, the speaker discusses the lateral closing wedge technique for high tibial osteotomy (HTO) and its goals, including unloading the affected compartment, stabilizing the joint, decreasing pain, protecting the meniscus, and delaying total knee arthroplasty (TKA). The speaker mentions that under-correction can lead to poor outcomes and recurrence of deformity, while multi-planar correction should be done in all planes. They also highlight the decreasing use of the lateral closing wedge technique in favor of opening wedge HTO. A meta-analysis is mentioned, which shows no significant difference in pain and survival rates between the two techniques. The speaker highlights the importance of considering factors such as correction required, arthritis stage, ligamentous instability, leg length discrepancy, weight, age, activity level, and surgeon preference when choosing between opening and closing wedge HTO. The closing wedge technique is described in detail, including the surgical procedure, potential contraindications, and advantages over opening wedge HTO. The speaker presents their own series of patients who underwent closing wedge HTO, with good long-term results, particularly in terms of alignment correction. Bone graft options for opening wedge HTO are briefly mentioned, as well as post-operative management, including hospital stay, crutch use, weight-bearing, pain management, and rehabilitation.

Asset Caption

Stefano Zaffagnini, MD

Keywords

lateral closing wedge technique

high tibial osteotomy

alignment correction

opening wedge HTO

pain reduction

joint stabilization