New Methods To Avoid Knee Replacements

Main Category: Bones / Orthopaedics
Article Date: 01 Dec 2008 - 7:00 PST

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Research published today in The Journal of Bone and Joint Surgery, British Volume summarises a number of recently developed techniques for patients that can avoid the need for knee replacements. Osteotomies around the knee had until the 1990's fallen out of favour with surgeons and knee replacement were performed instead, partly due to the complexities surrounding this treatment.

However, more recently new techniques have been developed and guidleines been issued that has led a trend back towards osteotomies among surgeons and the research discusses the current views on best practice surrounding patient selection, methods of fixation and operative techniques.

For high tibial osteotomy (HTO) the paper states that the main choice for patient selection 'is the correction of varus malalignment unicompartmental osteoarthritis of the knee'. In patients with this condition the degenerative process can be slowed and joint replacement delayed. In addition the authors believe that 'patients under 40 can benefit from realignment alone'.

The research recommends 'post-operative cryotherapy and intermittent venous compression' to reduce swelling and notes that 'the general principles of bone healing apply to closing-wedge osteotomies, which can be considered as optimally controlled fractures treated according to the standard protocol of fracture treatment'. This means that regular radiographs can be taken to monitor the progression of bone healing.

The research concludes that HTO is a 'viable treatment option for a well-defined patient group' and that new data shows 'the biplanar osteotomy fixed with an internal plate fixator is very stable' allowing early full weight-bearing and good bone healing without loss of correction.

Read the full text article.

Notes

- The Journal of Bone and Joint Surgery - British Volume is a world leading orthopaedics journal with an Impact Factor of 1.868

- JBJS-Br publishes twelve issues a year of high-quality, peer-reviewed research, overseen by an international editorial board led by Editor James Scott

- The Journal was first published in 1948 by The British Editorial Society of Bone and Joint Surgery, a registered charity (No. 209299), with the object of the advancement and improvement of education in orthopaedic surgery and allied branches of surgery and the diffusion of knowledge of new and improved methods of teaching and practicing orthopaedic surgery in all its branches

- You can find out more about The Journal at http://www.jbjs.org.uk

Journal of Bone and Joint Surgery, British Volume