High Tibial Osteotomy (HTO) is a common procedure performed to treat medial knee arthrosis.
There are two main goals for a HTO – first, to reduce knee pain by transferring weight-bearing loads to the relatively unaffected lateral ligament in varus knees; second, to delay the need for a knee replacement by stopping the destruction of the medial joint.
If your patient suffers from a condition known as osteoarthrosis or degenerative arthritis, typically they will experience a successive wearing on the menisci and articular cartilage, which may develop tears, and their knee function will become limited.
As mentioned, a high tibial osteotomy is often considered a method to extend the time before a knee replacement is necessary, and can delay this need for up to eight or even ten years.
Planning a High Tibial Osteotomy can be challenging without the appropriate tools and technology. Computer-assisted surgery has made major contributions to HTO, namely through pre-operative planning systems. These systems can be easy to manage. PeekMed software has proven to be user-friendly and intuitive for planning a surgery like this. The tool designed for osteotomy measures the correction angle of an HTO, i.e. the angle between the line from the center of the femoral head to a point at 62% of the medial-lateral distance of the knee, towards lateral, and a line drawn from that point to the center of the tibiotalar joint. PeekMed provides a widget to help positioning the point into the right location. The circle should be placed on the head of the femur, the tibial tray in the midline and the distal line in the tibial plafond. By doing this, the widget automatically calculates the angle needed for the correction.
There are a variety of surgical solutions for this problem. The PeekMed app is an advanced mobile application that helps surgeons to easily access their surgical planning anywhere and works alongside its software desktop program. With the PeekMed app, you can comfortably review and effectively communicate what you have planned with your team and your patient for more predictable outcomes.
During the surgery, a triangular wedge of bone is taken from the outer side of the tibia. This will help to realign the bone and help your patient’s weight to pass through the outer undamaged part of the knee.
To sum up, all patients are at risk of complications after the surgery but complications do not occur frequently and some can be avoid with a pre-operative planning. Some of the risks and complications may include:
- Anesthetic complications – these are extremely rare. The only regular side effects are postoperative dizziness and nausea;
- Pain – must be controlled using medication;
- Injuries on the surgical area – since it is located near a number of nerves and blood vessels;
- Swelling of the leg – this usually lasts for around two weeks. There is a numbness right next to the scar. Your patients should be able to support their full weight on their legs but it may be required for them to use braces for support;
- Infections – they can occur but are usually treated immediately;
- Compartment syndrome – it is a painful condition in which pressure within the muscles increases to dangerous levels;
- Deep vein thrombosis – It can be a serious issue, that can lead to a stroke or even be fatal if it blocks a large segment of the lung;
- Non-union – it occurs when the bone fails to unite, although it is very rare since the bone in this area has a good blood supply.