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Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner.

Publication ,  Journal Article
Savarese, E; Bisicchia, S; Romeo, R; Amendola, A
Published in: J Orthop Traumatol
March 2011

High tibial osteotomy (HTO) is a surgical procedure used to change the mechanical weight-bearing axis and alter the loads carried through the knee. Conventional indications for HTO are medial compartment osteoarthritis and varus malalignment of the knee causing pain and dysfunction. Traditionally, knee instability associated with varus thrust has been considered a contraindication. However, today the indications include patients with chronic ligament deficiencies and malalignment, because an HTO procedure can change not only the coronal but also the sagittal plane of the knee. The sagittal plane has generally been ignored in HTO literature, but its modification has a significant impact on biomechanics and joint stability. Indeed, decreased posterior tibial slope causes posterior tibia translation and helps the anterior cruciate ligament (ACL)-deficient knee. Vice versa, increased tibial slope causes anterior tibia translation and helps the posterior cruciate ligament (PCL)-deficient knee. A review of literature shows that soft tissue procedures alone are often unsatisfactory for chronic posterior instability if alignment is not corrected. Since limb alignment is the most important factor to consider in lower limb reconstructive surgery, diagnosis and treatment of limb malalignment should not be ignored in management of chronic ligamentous instabilities. This paper reviews the effects of chronic posterior instability and tibial slope alteration on knee and soft tissues, in addition to planning and surgical technique for chronic posterior and posterolateral instability with HTO.

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Published In

J Orthop Traumatol

DOI

EISSN

1590-9999

Publication Date

March 2011

Volume

12

Issue

1

Start / End Page

1 / 17

Location

Italy

Related Subject Headings

  • Weight-Bearing
  • Tibia
  • Posterior Cruciate Ligament
  • Osteotomy
  • Orthopedics
  • Knee Injuries
  • Joint Instability
  • Humans
  • Chronic Disease
  • 3202 Clinical sciences
 

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Savarese, E., Bisicchia, S., Romeo, R., & Amendola, A. (2011). Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner. J Orthop Traumatol, 12(1), 1–17. https://doi.org/10.1007/s10195-010-0120-0
Savarese, Eugenio, Salvatore Bisicchia, Rocco Romeo, and Annunziato Amendola. “Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner.J Orthop Traumatol 12, no. 1 (March 2011): 1–17. https://doi.org/10.1007/s10195-010-0120-0.
Savarese E, Bisicchia S, Romeo R, Amendola A. Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner. J Orthop Traumatol. 2011 Mar;12(1):1–17.
Savarese, Eugenio, et al. “Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner.J Orthop Traumatol, vol. 12, no. 1, Mar. 2011, pp. 1–17. Pubmed, doi:10.1007/s10195-010-0120-0.
Savarese E, Bisicchia S, Romeo R, Amendola A. Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner. J Orthop Traumatol. 2011 Mar;12(1):1–17.
Journal cover image

Published In

J Orthop Traumatol

DOI

EISSN

1590-9999

Publication Date

March 2011

Volume

12

Issue

1

Start / End Page

1 / 17

Location

Italy

Related Subject Headings

  • Weight-Bearing
  • Tibia
  • Posterior Cruciate Ligament
  • Osteotomy
  • Orthopedics
  • Knee Injuries
  • Joint Instability
  • Humans
  • Chronic Disease
  • 3202 Clinical sciences