Place and techniques of tibial osteotomies for the treatment of medial gonarthrosis

Osteotomies for gonarthrosis have been performed for over 50years and are able to stabilize the arthritic disease. These proceduresare in competition with uni or total knee arthroplasties. Howeverknee arthroplasties are not able to support a high activity levelfor a long time in young patients and osteotomies are the best indicationsin these cases. In varus knee which represents 90% of thecases, hypercorrection of the deformity is necessary with a valguscomprised between 3 and 6 degrees calculated on the mechanicalaxis of the femur and of the tibia. Several technical procedures existfor genu varum deformity which can to give good results after a 10to 15 year follow-up ; opening wedge tibial osteotomy or closingwedge, curviplane and dome osteotomies. Each technique has itsown advantages and disadvantages.