Lateral Closing Wedge Osteotomy of Tibia for Degenerative Arthritis / 대한정형외과학회잡지

Proximal tibial osteotomy is an effective, well-established treatment for unicompartmental arthritic knee with varus or valgus deformity. Four basic types are commonly described: lateral closing wedge osteotomy, medial open wedge osteotomy, dome osteotomy, and medial opening hemicallotasis. The objective of this procedure is to realign the weight-bearing axis through the knee by redistributing the forces of weight to the less involved compartment of the knee. With thorough preoperative planning and careful selection of patients, optimal outcome can be expected with preservation of the patient's joint. In this article, we reviewed selection of patients, surgical planning, surgical technique, complications, pre- and post-operative change in mechanics, and long term surgical outcome of closing wedge osteotomy. Optimal outcome is expected in patients with young age (younger than 60), stable knee, medially confined osteoarthritis, and good range of motion. According to the literature, average 10-year survival rate is expected to be 60% to 90%. Closing wedge osteotomy allows for rapid bone healing, early weight bearing, rehabilitation, and low rates of correction loss. Surgeons should keep in mind that optimal indication, preoperative planning, and use of safe operative technique are essential to achievement of best results.

Lateral Condyle Prominence Following Lateral Closing Wedge Osteotomy for Cubitus Varus Deformity / 대한정형외과학회잡지

PURPOSE: To define the significant factors for lateral condyle prominence following the lateral closing wedge osteotomy for cubitus varus. MATERIALS AND METHODS: Analyzed the 15 cases performed lateral closing wedge osteotomy for cubitus varus. We measured the carrying angle by the arm and forearm axis lines of soft tissues, lateral condyle prominence index, the distance from center of rotation to osteotomy site and the distance from center of rotation to elbow joint. RESULTS: The lateral condyle prominence group with lateral condyle prominence index (LCPI) over 300% was 5 cases (33%), and no prominence group was 10 cases (67%). The distance between CORA and osteotomy site in lateral condyle prominence group was mean 44 mm (range, 35-52) and no prominence group was mean 21 mm (range, 17-27). The distance between CORA and elbow joint was mean -3 mm (range -15~7) and 16 mm (range, 8-24) respectively. CONCLUSION: Lateral condyle prominence was developed in case of the increased preoperative LCPI, increased distance between CORA and osteotomy site, and decreased distance between CORA and elbow joint.