High tibial osteotomy (HTO) is a common treatment for medial compartment arthritis of the knee in younger, more active patients. The HTO shifts load away from the degenerative medial compartment and into the lateral compartment. This change can be accomplished with either a lateral closing or a medial opening wedge HTO. An HTO also potentially affects leg length. Mathematical models predict that the osteotomy type (opening versus closing) and the magnitude of the correction determine the change in leg length, but no in vivo studies have been published. The purpose of this study is to quantify and compare leg length change following opening and closing wedge HTO. Retrospective cohort study – Level III evidenceIntroduction:
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Appropriate positioning of total knee arthroplasty (TKA) components is a key concern of surgeons. Post-operative varus alignment has been associated with poorer clinical outcome scores and increased failure rates. However, obtaining neutral alignment can be challenging in cases with significant pre-operative varus deformity 1) In patients with pre-operative varus deformities, does residual post-operative varus limb alignment lead to increased revision rates or poorer outcome scores compared to correction to neutral alignment? 2) Does placing the tibial component in varus alignment lead to increased revision rates and poorer outcome scores? 3) Does femoral component alignment affect revision rates and outcome scores? 4) Do these findings change in patients with at least 10 degrees of varus alignment pre-operatively?Background:
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