High tibial osteotomies in the young active patient

Abstract

Unicompartmental changes in the knee of a young athlete remains a difficult and controversial problem in orthopaedics. Excessive premature loading of articular cartilage, most often the result of a knee injury, has been shown to result in increased degenerative changes and pain in the younger patient. Instability may also contribute to the degeneration of cartilage and must therefore be considered in the treatment of osteoarthritis in the young adult. High tibial osteotomy has been described as a treatment option for malalignment in the older, less active adult and has shown promising results in a younger, more active population. Osteotomies for instability are more controversial and should be considered in more complex injury patterns.

Fig. 1

Alignment drawn by authors

Fig. 2

ACL deficient knee with varus angulation. Pre- and post-op radiographs

Fig. 3

Preoperative radiograph demonstrating varus alignment

Fig. 4

Intraoperative lateral radiograph after fixation

Fig. 5

Intraoperative AP radiograph after fixation

Fig. 6

Postoperative weight-bearing radiograph demonstrating correction of alignment

Fig. 7

Final postoperative radiographs with bone consolidation a) AP view, b) lateral view