S2033 HIGH TIBIAL OSTEOTOMY

Tibial osteotomy is a time-honored procedure in the treatment of medial femorotibial osteoarthritis. However new points need to be discussed in a modern approach of this technique. What factors have a bearing on the decision and the technique ? During this symposium will be discussed: the advantages of the tibial opening versus closing wedge; the possibility to avoid bone grafts by using bone ceramics for opening wedge osteotomies; the importance of reliable fixation technique; the importance of decreasing the posterior slope of the tibia if the osteotomy is done on a knee with an anterior cruciate deficiency. How long is tibial osteotomy effective and what are the outcome of postosteotomy procedures after failure of the osteotomy: most of the data indicate that tibial osteotomy is very often effective and, that achieving a moderate degree of valgus is a decisive factor in the long term osteotomy survival. However since the patients are young at the tissue of the osteotomy and since the results deteriorate over the time, the subsequent procedures should be discussed. Can a second osteotomy be done after failure of the first osteotomy ? Is it possible to perform a unicompartmental arthroplasty after a high tibial osteotomy ? What are the technical problems of a total knee arthroplasty after a high tibial osteotomy ?