الفهرس | Only 14 pages are availabe for public view |
Abstract Genu varum is a common deformity associated with medial compartmental osteoarthritic knee with subsequent mechanical axis deviation and stress disturbances across the knee joint with medial compartmental loading. Good prognostic factors for HTO are preoperative TBVA>5°, anatomical valgus alignment of ≥8° at five weeks post operation, age<50 years, excellent preoperative Knee Society score, and Ahlback grade 0 arthritis of medial plateau. Negative prognostic factors are obesity especially more than 1.3 times of the normal population weight, nicotine users, valgus alignment of ≤5° at five weeks post operation, postoperative flexion<120°, and age>56 years old. Preoperative measurements of the degree of varus deformity are so essential to overcorrect the deformity and putting the knee in net valgus position to shift the arc of body weight to the healthy lateral compartment. Choice of osteotomy depends on degree of varus. Up to 10 degrees can be corrected with a transverse LCWHTO, varus up 15 degrees can be corrected with MOWHTO, varus up 20 degrees can be corrected with Wagner’s oblique LCWHTO and varus above 20 degrees can be corrected with dome osteotomy.There is no significant difference in outcome and survival between open medial and closed lateral high tibia osteotomy, but medial opening HTO has been more popular recently due to its advantages over closed HTO. |