Zusammenfassung
Kniegelenknahe Korrekturosteotomien bei unikompartimenteller Gonarthrose haben in den letzten Jahren eine starke Renaissance erlebt. Sie müssen als Alternative zum monokompartimentellen oder kompletten Gelenkersatz mit bedacht werden.
Abstract
Osteotomies around the knee in unicompartimental osteoarthritis had an impressing revival in the past few years and have to be kept in mind as an alternative to total knee arthroplasty. The most frequent type of osteotomies around the knee is the medial open wedge high tibia osteotomy (MOWHTO). But still also closed wedge high tibia osteotomies (CWHTO) have their relevance in many cases. Distal femur osteotomies (DFO) are used more and more frequently in most cases as closed wedge, the open wedge DFO shows more problems in bone healing. All osteotomies with isolated correction in frontal plane should be done with a biplanar bonecut. In cases of severe varus and valgus malalignment a double-level osteotomy (combined femoral and tibial osteotomy) has to be executed. Severity and frequency of adverse events in osteotomies around the knee are mostly comparable to those in arthroplasty, except non-union which is only related to osteotomies and more often seen in smokers. There are nearly no age limits for osteotomies around the knee. Ten years-survival in HTOs are about 85 to 91% according to literature.
Schlüsselwörter
Arthrose - Gonarthrose - Umstellungsosteotomie - Korrekturosteotomie - aufklappende Tibiakopfosteotomie - intraartikuläre Fehlstellungen - Tibiakopffraktur
Key words
osteoarthritis - tibial fracture - knee surgery - tibial osteotomy - femoral osteotomy
