Actualización de la osteotomía tibial en el genu varo

  • Miguel Ángel Sánchez Bosque Miembro Sato
  • Jorge García Díaz
  • Miguel Ángel Olcina Meseguer
  • Ángel David García Mayorgas
  • Antonio José Cuevas Pérez
  • Rafael Antonio Quevedo Reinoso
Palabras clave: Rodilla, Osteotomía proximal de tibia, Osteoartrosis medial, Osteotomía de adición medial, Osteotomía de sustracción lateral

Resumen

La osteoartrosis en el compartimento medial de la rodilla es una causa frecuente de dolor crónico e impotencia funcional en nuestro medio. Los tratamientos clínicamente efectivos incluyen el tratamiento conservador, la artroplastia unicompartimental y la osteotomía. Si bien la prótesis unicompartimental puede ser una buena elección en determinados casos, para pacientes jóvenes con una mala alineación de los miembros inferiores se prefieren las osteotomías alrededor de la rodilla con el propósito de redistribuir el eje de carga. Las osteotomías son variadas dependiendo del grado de deformidad y su localización. La más utilizada en la actualidad es la osteotomía tibial valguizante, debido a que la mayoría de genu varo artrósico está causada por una deformidad en tibia. Dentro de las osteotomías valguizantes de tibia podemos encontrar: la osteotomía de adición medial, la de sustracción lateral y la osteotomía tridimensional.

Citas

Liu X, Chen Z, Gao Y, Zhang J, Jin Z. High Tibial Osteotomy: Review of Techniques and Biomechanics. J Healthc Eng [Internet]. 2019 [cited 2023 Jun 1];2019. Available from: /pmc/articles/PMC6525872/

Osti M, Gohm A, Schlick B, Benedetto KP. Complication rate following high tibial open-wedge osteotomy with spacer plates for incipient osteoarthritis of the knee with varus malalignment. Knee Surg Sports Traumatol Arthrosc [Internet]. 2015 Jul 19 [cited 2023 Jun 1];23(7):1943–8. Available from: https://pubmed.ncbi.nlm.nih.gov/24193218/

Paley D, Pfeil J. [Principles of deformity correction around the knee]. Orthopade [Internet]. 2000 Jan 25 [cited 2023 Jun 1];29(1):0018–38. Available from: https://pubmed-ncbi-nlm-nih-gov.bvsspa.idm.oclc.org/10663243/

Feucht MJ, Winkler PW, Mehl J, Bode G, Forkel P, Imhoff AB, et al. Isolated high tibial osteotomy is appropriate in less than two-thirds of varus knees if excessive overcorrection of the medial proximal tibial angle should be avoided. Knee Surg Sports Traumatol Arthrosc [Internet]. 2021 Oct 1 [cited 2023 May 16];29(10):3299–309. Available from: https://pubmed.ncbi.nlm.nih.gov/32691093/

Micicoi G, Khakha R, Kley K, Wilson A, Cerciello S, Ollivier M. Managing intra-articular deformity in high Tibial osteotomy: a narrative review. J Exp Orthop [Internet]. 2020 Dec 1 [cited 2023 Jun 6];7(1). Available from: /pmc/articles/PMC7481321/

Spahn G, Klinger HM, Harth P, Hofmann GO. [Cartilage regeneration after high tibial osteotomy. Results of an arthroscopic study]. Z Orthop Unfall [Internet]. 2012 [cited 2023 Jun 1];150(3):272–9. Available from: https://pubmed.ncbi.nlm.nih.gov/22729374/

Feucht MJ, Minzlaff P, Saier T, Cotic M, Südkamp NP, Niemeyer P, et al. Degree of axis correction in valgus high tibial osteotomy: proposal of an individualised approach. Int Orthop [Internet]. 2014 Nov 1 [cited 2023 Jun 6];38(11):2273–80. Available from: https://pubmed.ncbi.nlm.nih.gov/25008139/

Fujisawa Y, Masuhara K, Shiomi S. The Effect of High Tibial Osteotomy on Osteoarthritis of the Knee: An Arthroscopic Study of 54 Knee Joints. Orthopedic Clinics of North America. 1979 Jul 1;10(3):585–608.

Elson DW, Petheram TG, Dawson MJ. High reliability in digital planning of medial opening wedge high tibial osteotomy, using Miniaci’s method. Knee Surg Sports Traumatol Arthrosc [Internet]. 2015 Jul 19 [cited 2023 Jun 21];23(7):2041–8. Available from: https://pubmed.ncbi.nlm.nih.gov/24584646/

Blackburn J, Ansari A, Porteous A, Murray J. Reliability of two techniques and training level of the observer in measuring the correction angle when planning a high tibial osteotomy. Knee [Internet]. 2018 Jan 1 [cited 2023 Jun 21];25(1):130–4. Available from: https://pubmed.ncbi.nlm.nih.gov/29223707/

Sivertsen EA, Vik J, Meland ASV, Nerhus TK. The Dugdale planning method for high tibial osteotomies underestimates the correction angle compared to the Miniaci method. Knee Surg Sports Traumatol Arthrosc [Internet]. 2023 Apr 1 [cited 2023 Dec 12];31(4):1507–14. Available from: https://pubmed.ncbi.nlm.nih.gov/34244828/

Hernigou P, Ma W. Open wedge tibial osteotomy with acrylic bone cement as bone substitute. Knee. 2001;8(2):103–10.

Nicolau X, Bonnomet F, Micicoi G, Eichler D, Ollivier M, Favreau H, et al. Accuracy of the correction obtained after tibial valgus osteotomy. Comparison of the use of the Hernigou table and the so-called classical method. Int Orthop [Internet]. 2020 Dec 1 [cited 2023 Jun 4];44(12):2613–9. Available from: https://pubmed.ncbi.nlm.nih.gov/32820360/

Nicolau X, Jenny JY, Bonnomet F, Ollivier M, Favreau H, Ehlinger M. Accuracy of the correction achieved after a valgus high tibial osteotomy: Comparison of the Hernigou table and navigation. Orthop Traumatol Surg Res [Internet]. 2022 May 1 [cited 2023 Jun 4];108(3). Available from: https://pubmed.ncbi.nlm.nih.gov/35151890/

van Haeringen MH, Kuijer PPFM, Daams JG, van Geenen RCI, Brinkman JM, Kerkhoffs GMMJ, et al. Correction to: Opening and closingwedge high tibial osteotomy are comparable and early full weight bearing is safe with angular stable plate fixation: a metaanalysis. Knee Surg Sports Traumatol Arthrosc [Internet]. 2023 [cited 2023 Jun 1]; Available from: https://pubmed.ncbi.nlm.nih.gov/36631558/

Song SJ, Yoon KH, Kim K Il, Park CH. Closed-wedge high tibial osteotomy is more advantageous to maintain the correction than open-wedge high tibial osteotomy in osteopenic patients. Knee Surgery, Sports Traumatology, Arthroscopy [Internet]. 2022 Apr 1 [cited 2023 Jun 1];31(4):1563–70. Available from: https://link.springer.com/article/10.1007/s00167-022-07006-2

Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Does obesity and nicotine abuse influence the outcome and complication rate after open-wedge high tibial osteotomy? A retrospective evaluation of five hundred and thirty three patients. Int Orthop [Internet]. 2014 Jan [cited 2023 Jun 3];38(1):55–60. Available from: https://pubmed.ncbi.nlm.nih.gov/24022738/

Howells NR, Salmon L, Waller A, Scanelli J, Pinczewski LA. The outcome at ten years of lateral closing-wedge high tibial osteotomy: determinants of survival and functional outcome. Bone Joint J [Internet]. 2014 Nov 1 [cited 2023 Jun 3];96-B(11):1491–7. Available from: https://pubmed.ncbi.nlm.nih.gov/25371462/

Kanakamedala AC, Gipsman A, Lowe DT, Strauss EJ, Alaia MJ. Combined Anterior Opening-Wedge High Tibial Osteotomy and Tibial Tubercle Osteotomy with Posterior Cruciate Ligament Reconstruction. Arthrosc Tech [Internet]. 2022 Apr 1 [cited 2023 Jun 4];11(4):e601–8. Available from: https://pubmed.ncbi.nlm.nih.gov/35493047/

Klek M, Dhawan A. The Role of High Tibial Osteotomy in ACL Reconstruction in Knees with Coronal and Sagittal Plane Deformity. Curr Rev Musculoskelet Med [Internet]. 2019 Dec 1 [cited 2023 Jun 4];12(4):466–71. Available from: https://pubmed.ncbi.nlm.nih.gov/31760623/

Bosco F, Giustra F, Giai Via R, Lavia AD, Capella M, Sabatini L, et al. Could anterior closed-wedge high tibial osteotomy be a viable option in patients with high posterior tibial slope who undergo anterior cruciate ligament reconstruction? A systematic review and meta-analysis. Eur J Orthop Surg Traumatol [Internet]. 2022 [cited 2023 Jun 4]; Available from: https://pubmed.ncbi.nlm.nih.gov/36308547/

Murray R, Winkler PW, Shaikh HS, Musahl V. High Tibial Osteotomy for Varus Deformity of the Knee. JAAOS Global Research & Reviews [Internet]. 2021 Jul 9 [cited 2023 May 16];5(7). Available from: /pmc/articles/PMC8274793/

Kim DH, Kim SC, Yoon JS, Lee YS. Are There Harmful Effects of Preoperative Mild Lateral or Patellofemoral Degeneration on the Outcomes of Open Wedge High Tibial Osteotomy for Medial Compartmental Osteoarthritis? Orthop J Sports Med [Internet]. 2020 Jun 1 [cited 2023 Jun 3];8(6). Available from: https://pubmed.ncbi.nlm.nih.gov/32637430/

Jingbo C, Mingli F, Guanglei C, Zheng L, Shuai A, Jiang H. Patellar Height Is Not Altered When the Knee Axis Correction Is Less than 15 Degrees and Has Good Short-Term Clinical Outcome. Journal of Knee Surgery [Internet]. 2020 Jun 1 [cited 2023 Jun 3];33(6):536–46. Available from: https://pubmed.ncbi.nlm.nih.gov/30877687/

Bin S Il, Kim HJ, Ahn HS, Rim DS, Lee DH. Changes in Patellar Height After Opening Wedge and Closing Wedge High Tibial Osteotomy: A Meta-analysis. Arthroscopy [Internet]. 2016 Nov 1 [cited 2023 Jun 3];32(11):2393–400. Available from: https://pubmed.ncbi.nlm.nih.gov/27570171/

Song JH, Bin S Il, Kim JM, Lee BS. What Is An Acceptable Limit of Joint-Line Obliquity After Medial Open Wedge High Tibial Osteotomy? Analysis Based on Midterm Results. Am J Sports Med [Internet]. 2020 Oct 1 [cited 2023 May 15];48(12):3028–35. Available from: https://pubmed.ncbi.nlm.nih.gov/32941061/

Akamatsu Y, Nejima S, Tsuji M, Kobayashi H, Muramatsu S. Joint line obliquity was maintained after double-level osteotomy, but was increased after open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc [Internet]. 2022 Feb 1 [cited 2023 May 15];30(2):688–97. Available from: https://pubmed.ncbi.nlm.nih.gov/33433634/

Akamatsu Y, Kumagai K, Kobayashi H, Tsuji M, Saito T. Effect of Increased Coronal Inclination of the Tibial Plateau After Opening-Wedge High Tibial Osteotomy. Arthroscopy [Internet]. 2018 Jul 1 [cited 2023 May 15];34(7):2158-2169.e2. Available from: https://pubmed.ncbi.nlm.nih.gov/29685834/

Feucht MJ, Winkler PW, Mehl J, Bode G, Forkel P, Imhoff AB, et al. Isolated high tibial osteotomy is appropriate in less than two-thirds of varus knees if excessive overcorrection of the medial proximal tibial angle should be avoided. Knee Surgery, Sports Traumatology, Arthroscopy [Internet]. 2021 Oct 1 [cited 2023 Jun 1];29(10):3299–309. Available from: https://link-springer-com.bvsspa.idm.oclc.org/article/10.1007/s00167-020-06166-3

Ferrera A, Menetrey J. Optimizing indications and technique in osteotomies around the knee. EFORT Open Rev [Internet]. 2022 [cited 2023 Jun 4];7(6):396–403. Available from: https://pubmed.ncbi.nlm.nih.gov/35674119/

Zhao B, Xiao Q, Liu B. Effects of High Tibial Osteotomy Combined with Arthroscopy on Pain and Inflammation Markers in Patients with Medial Knee Osteoarthritis. J Invest Surg [Internet]. 2022 [cited 2023 May 17];35(4):891–7. Available from: https://pubmed.ncbi.nlm.nih.gov/34157925/

Nakamura R, Komatsu N, Fujita K, Kuroda K, Takahashi M, Omi R, et al. Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy. Bone Joint J [Internet]. 2017 Oct 1 [cited 2023 May 15];99-B(10):1313–8. Available from: https://pubmed.ncbi.nlm.nih.gov/28963152/

Gulagaci F, Jacquet C, Ehlinger M, Sharma A, Kley K, Wilson A, et al. A protective hinge wire, intersecting the osteotomy plane, can reduce the occurrence of perioperative hinge fractures in medial opening wedge osteotomy. Knee Surg Sports Traumatol Arthrosc [Internet]. 2020 Oct 1 [cited 2023 May 15];28(10):3173–82. Available from: https://pubmed.ncbi.nlm.nih.gov/31773202/

Han JH, Kim HJ, Song JG, Yang JH, Bhandare NN, Fernandez AR, et al. Is Bone Grafting Necessary in Opening Wedge High Tibial Osteotomy? A Meta-Analysis of Radiological Outcomes. Knee Surg Relat Res [Internet]. 2015 Dec 1 [cited 2023 May 15];27(4):207–20. Available from: https://pubmed.ncbi.nlm.nih.gov/26675553/

Slevin O, Ayeni OR, Hinterwimmer S, Tischer T, Feucht MJ, Hirschmann MT. The role of bone void fillers in medial opening wedge high tibial osteotomy: a systematic review. Knee Surg Sports Traumatol Arthrosc [Internet]. 2016 Nov 1 [cited 2023 May 15];24(11):3584–98. Available from: https://pubmed.ncbi.nlm.nih.gov/27557796/

Haghpanah B, Kaseb MH, Espandar R, Mortazavi SMJ. No difference in union and recurrence rate between iliac crest autograft versus allograft following medial opening wedge high tibial osteotomy: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc [Internet]. 2021 Oct 1 [cited 2023 May 15];29(10):3375–81. Available from: https://pubmed.ncbi.nlm.nih.gov/32839849/

van Haeringen MH, Kuijer PPFM, Daams JG, van Geenen RCI, Brinkman JM, Kerkhoffs GMMJ, et al. Opening- and closing-wedge high tibial osteotomy are comparable and early full weight bearing is safe with angular stable plate fixation: a meta-analysis. Knee Surg Sports Traumatol Arthrosc [Internet]. 2022 [cited 2023 May 15]; Available from: https://pubmed.ncbi.nlm.nih.gov/36473985/

Han JH, Kim HJ, Song JG, Yang JH, Nakamura R, Shah D, et al. Locking plate versus non-locking plate in open-wedge high tibial osteotomy: a meta-analysis. Knee Surg Sports Traumatol Arthrosc [Internet]. 2017 Mar 1 [cited 2023 May 15];25(3):808–16. Available from: https://pubmed.ncbi.nlm.nih.gov/26578305/

Takeuchi R, Ishikawa H, Kumagai K, Yamaguchi Y, Chiba N, Akamatsu Y, et al. Fractures around the lateral cortical hinge after a medial opening-wedge high tibial osteotomy: a new classification of lateral hinge fracture. Arthroscopy [Internet]. 2012 Jan [cited 2023 May 16];28(1):85–94. Available from: https://pubmed.ncbi.nlm.nih.gov/21982387/

Goshima K, Sawaguchi T, Shigemoto K, Iwai S, Nakanishi A, Inoue D, et al. Large opening gaps, unstable hinge fractures, and osteotomy line below the safe zone cause delayed bone healing after open-wedge high tibial osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy [Internet]. 2019 Apr 5 [cited 2023 Jun 1];27(4):1291–8. Available from: https://link.springer.com/article/10.1007/s00167-018-5334-3

Goshima K, Sawaguchi T, Shigemoto K, Iwai S, Fujita K, Kataoka T. Plate removal without loss of correction after open-wedge high tibial osteotomy is possible when posterior cortex bone union reaches osteotomy gap center even in incompletely filled gaps. Knee Surgery, Sports Traumatology, Arthroscopy [Internet]. 2020 Jun 1 [cited 2023 Jun 1];28(6):1827–34. Available from: https://link.springer.com/article/10.1007/s00167-019-05615-y

Publicado
2023-12-18
Número
Vol. 40 Núm. 1 (2023)
Sección
Artículos de Revisión
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
  1. Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
  2. Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
  3. Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).