J Knee Surg 2017; 30(08): 764-768
DOI: 10.1055/s-0037-1603792
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

High Tibial Osteotomy following Biologic Replacement of the Knee

James T. Stannard
1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
,
James P. Stannard
1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
› Author Affiliations
Further Information

Publication History

03 April 2017

03 May 2017

Publication Date:
28 June 2017 (online)

Abstract

Biologic unicondylar replacement with fresh osteoarticular allografts of the femoral condyle and tibial plateau plus a meniscus transplant provides an option for young or active patients with severe articular cartilage loss. The timing of osteotomy procedures to correct malalignment either before, concurrent, or after allograft implantation has become an area of research interest. Concurrent osteotomies and allograft transplantation have become increasingly popular due to the decreased patient morbidity from multiple surgeries that require a period of toe-touch weight bearing (TTWB) postoperatively. We discuss here our techniques for correcting malalignment, which concurrently repair major bipolar knee lesions while transplanting the meniscus. We prefer to perform a simultaneous biologic unicondylar replacement with an osteotomy, if needed. Weight bearing alignment radiographs should be obtained 6 weeks following surgery to confirm the intraoperative findings that were obtained using fluoroscopy and the alignment rod. If malalignment persists and the biologic grafts are overloaded, a staged osteotomy should be performed as soon as possible.

 
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