CORR Insights^®: Injury Risk to Extraosseous Knee Vasculature During Osteotomies: A Cadaveric Study With CT and Dissection Analysis

Excerpt

Knee malalignment increases forces through the knee during activities of daily living and increases the risk of osteoarthritis [11]. Correction of malalignment through distal femoral osteotomy (DFO) or proximal tibial osteotomy (PTO) is an accepted treatment to improve symptoms and delay disease progression [1]. However, the role of DFO and PTO in treating incipient unicompartmental osteoarthritis of the knee has been questioned, especially after the advent of unicompartmental knee replacement. Today, knee osteotomies are primarily used to treat incipient to moderate unicompartmental knee osteoarthritis in younger and active patients [15] who wish to resume high intensity sporting activities [4]. The popularity of knee osteotomies has fluctuated as changes in technique and results have been reported. Patients who avoid postoperative complications are more likely to report better outcomes after knee osteotomy [5]. Excluding progression of osteoarthritis, complications after knee osteotomy primarily are related to the healing of the osteotomy and the soft tissue envelope, including infection [9]. Dissection that protects the regional blood supply is recognized to facilitate not only fracture (and therefore osteotomy) healing [8], but also wound healing, perhaps reducing the risk of surgical infections [2]. …