High Tibial Osteotomy is done for treating osteoarthritis confined to the medial compartment by Dr Atit Tiwari

Medial opening wedge High Tibial Osteotomy for Early Arthritis knee

1. High Tibial osteotomy Dr ATIT TIWARI MS Ortho [KEM MUMBAI], FASM SHOULDER FELLOWSHIP [AUSTRALIA] SHIVAM ORTHOCARE HOSPITAL, UNA

2. -1958

3. Goals Reduce Knee Pain Delay TKR

4. Whom to operate?? Moderately active, high demand(40-60) Isolated medial osteoarthritis Metaphyseal Varus ( TBVA>5 o ) Good ROM NO instability

5. Extended indications -Ligamentous instability with varus malalignment -Meniscus root repair - Varus malalignment and chondral resurfacing procedures

6. Poor prognostic factors

7. Pagoda deformity

8. Measurements 1) MAD II) mMPTA III) JLCA

9. If JLCA >5 No HTO TCVO

10. 1 II III

11. FUJISAWA POINT 3-5 o of MA valgus 62.5% of Tibial plateau width

12. CASES

13. CASE I

14. CASE II

15. CASE III, Age 39 F, BMI 29

16. Complications of MOWHTO Non Union Implant failure Hinge fracture

17. HTO or uka ???

18. TKA after hto vs primary tka

19. HTO -TKA vs I o TKA

20. Revision tka Significantly higher in HTO TKA group A) Aseptic loosening of Tibial component B) Malalignment of prox tibia due to over correction C) Scar tissue between patellar tendon and TT

21. Patient selection The value of follow up!

22. Thank you