Osteotomies around the Knee–Part II

Osteoarthritis of the knee is a disabling and prevalent condition in the contemporary society. It has a broad spectrum of presentation and is becoming more common at younger ages, especially because of repetitive trauma, as we notice in the practice of high-impact sports activities, or as the outcomes of knee injuries. Osteotomies are surgical procedures aimed to preserve the joint by improving its biomechanics. This is the second special focus section of the Journal of Knee Surgery dedicated to this topic, where we have the privilege to get access to seven original contributions. The assessment and correction of the tibial slope are critical in cases of cruciate-deficient knees. This topic is covered in the article dedicated to sagittal plane corrections around the knee. The current principles of management in valgus knees are presented here, highlighting the advantages of a closing-wedge technique. Complex deformities may be addressed at two levels, above and below the knee, to avoid the obliquity of the joint line, and this is very well illustrated in the article about combined osteotomies. Joint salvage procedures are of keen interest in young and active patients. A new alternative that combines osteotomy and biological joint resurfacing with osteochondral and meniscal allografts is a very original article of this section. The pendulum between high-tibial osteotomy and unicompartmental knee replacement has been the scope of the literature in cases of varus knee. We present a review of this topic characterizing that each of them has unique indications. Another myth is that total knee replacements may be challenging after previous osteotomies around the joint. This topic is also covered here by presenting the current literature evidence based on more modern osteotomy techniques. Finally, osteotomies are shown as an alternative for cases of failed tibial plateau fractures, postponing or even preventing the substitution of the joint. Very experienced authors were invited to contribute to this special focus section, and we hope that it may collaborate with your understanding of indications, planning, execution, and outcomes of osteotomies around the knee. Enjoy reading!