Closing wedge tibial osteotomy has been the gold standard in proximal osteotomy procedures to correct uni-compartmental osteoarthritis. Opening wedge tibial osteotomies are achieving similar long-term results while avoiding some of the pitfalls of the closing wedge procedure. Opening wedge osteotomies maintain patellar length, tibial inclination, and proximal tibia bone stock. This allows for a technically easier conversion to a total knee arthroplasty in the future.

The purpose of this study was to assess the functional outcomes as well as the anatomical changes caused by opening wedge high tibial osteotomy

Opening and closing wedge osteotomies have been shown to have near equivolent long-term results. Using functional outcome studies (SF-36 and WOMAC ) and radiographic review we have shown good outcomes while maintaining the original anatomy of the knee.

Opening wedge tibial osteotomy will allow for a less complicated conversion to a total knee arthroplasty than the closing wedge tibial osteotomy

The patients attained a significant valgus correction that was maintained postoperatively (pre-op 6.12 varus to 5.5 valgus)

Clinical status of the patient was improved significantly in the functional outcomes testing using the WOMAC knee score( pre-op value 29.75 to 19.5; p = 0.0318 ) and the SF-36 ( pre-op value 64.4 to 81.7; p = 0.0035 ).

Patellar height (Pre-op Insall-Salvati ratio 1.15 to 1.09; p = 0.2339 ) and tibial inclination( pre-op 7.3 degrees to 6.85 degrees; p = 0.6743 ) were maintained.

This study retrospectively examined twenty-two patients with medial joint uni-compartmental osteoarthritis. Radiographic review of the pre-operative and post-operative films assessed the valgus correction, patellar height, and tibial inclination. The patients were seen in follow-up to assess the clinical exam and functional outcomes were measured using the SF-36 and WOMAC knee scores.

Opening wedge HTO is able to achieve acceptable correction of deformity while maintaining the normal anatomy of the knee.

Closing wedge tibial osteotomy has been the gold standard in proximal osteotomy procedures to correct uni-compartmental osteoarthritis. Opening wedge tibial osteotomies are achieving similar long-term results while avoiding some of the pitfalls of the closing wedge procedure. Opening wedge osteotomies maintain patellar length, tibial inclination, and proximal tibia bone stock. This allows for a technically easier conversion to a total knee arthroplasty in the future.

The purpose of this study was to assess the functional outcomes as well as the anatomical changes caused by opening wedge high tibial osteotomy

Opening and closing wedge osteotomies have been shown to have near equivolent long-term results. Using functional outcome studies (SF-36 and WOMAC ) and radiographic review we have shown good outcomes while maintaining the original anatomy of the knee.

Opening wedge tibial osteotomy will allow for a less complicated conversion to a total knee arthroplasty than the closing wedge tibial osteotomy

The patients attained a significant valgus correction that was maintained postoperatively (pre-op 6.12 varus to 5.5 valgus )

Clinical status of the patient was improved significantly in the functional outcomes testing using the WOMAC knee score( pre-op value 29.75 to 19.5; p = 0.0318 ) and the SF-36 ( pre-op value 64.4 to 81.7; p = 0.0035 ).

Patellar height (Pre-op Insall-Salvati ratio 1.15 to 1.09; p = 0.2339 ) and tibial inclination( pre-op 7.3 degrees to 6.85 degrees; p = 0.6743 ) were maintained.

This study retrospectively examined twenty-two patients with medial joint uni-compartmental osteoarthritis. Radiographic review of the pre-operative and post-operative films assessed the valgus correction, patellar height, and tibial inclination. The patients were seen in follow-up to assess the clinical exam and functional outcomes were measured using the SF-36 and WOMAC knee scores.

Opening wedge HTO is able to achieve acceptable correction of deformity while maintaining the normal anatomy of the knee.

The purpose of the present study is to determine a correlation between articular cartilage changes and underlying bone contusions in ACL-deficient knees. Analysis of surgical and MRI findings in thirty-seven knees shows that medial femoral condyle and medial tibial plateau bone contusions, present in 30% of ACL injuries, correlate strongly with articular cartilage damage, irrespective of meniscal status. Although lateral compartment bone contusions are more commonly seen following injury, we have not found this to be associated with the status of the overlying cartilage. Degenerative changes in the ACL-deficient knee are multifactorial, but medial compartment bone contusions may be an important contributor that warrants further investigation.

Despite successful reconstruction of the anterior cruciate ligament, many patients eventually develop osteoarthritis, suggesting that something in addition to mechanical instability may contribute. The purpose of the present study is to determine a correlation between articular cartilage changes and underlying bone contusions in ACL-deficient knees.

Between January 2002 and March 2003, sixty-eight knees consecutively underwent ACL reconstruction at our institution. Presence and location of bone contusions on MRI were noted, and correlated to presence of articular cartilage changes and meniscal pathology witnessed during surgery.

Of the sixty-eight knees operated, thirty-one were excluded because of either: pre-existing arthritis, previous surgery, presence of multiple ligament injury, or absence of bone contusions on MRI. In the analysis of the thirty-seven remaining knees, bone contusions were present on the medial tibial plateau and medial femoral condyle in 30%, on the lateral tibial plateau in 84%, and on the lateral femoral condyle in 73%. Articular cartilage damage is most commonly seen on the medial femoral condyle, irrespective of meniscal status. Analysis using Fisher’s Exact test shows that medial femoral condyle (p=0.026) and medial tibial plateau articular cartilage damage (p= 0.011) is strongly correlated with presence of underlying bone contusions. No association was found between lateral compartment articular cartilage status and presence of bone contusions.

Although lateral compartment bone contusions are common following ACL injuries, we have not found an association with cartilage damage. Degenerative changes in the ACL-deficient knee are multifactorial, but medial compartment bone contusions may be an important contributor.