Osteotomy around the painful degenerative varus knee: a 2022 ESSKA formal consensus

Excerpt

Osteotomy around the knee joint enjoys a unique identity in the armamentarium of the surgeon treating degenerative disease. Whilst many pharmacological agents, biological treatments, and indeed knee arthroplasty are the product of technological advances of recent decades, the practice of deformity correction has been with us for centuries [16]. The principles of osteotomy evolved at the time of Hippocrates and later with the practitioners of osteoclasis in the sixteenth century [1]. More regular osteotomy practice followed the pioneering work of Barton and MacEwan [9] in the nineteenth century. Correction of deformity for the treatment of pain naturally followed the evidential success of these earlier procedures and mechanical offloading of the diseased osteoarthritic compartment of a knee in the presence of deformity became a mainstay of management for knee arthritis into the latter half of the twentieth century [5, 13]. Such a treatment follows a natural therapeutic intuition which is to straighten deformity where such a situation leads to hardship and pain. The practice of osteotomy truly reflects the derivation of ‘orthopedie’ from the Greek word orthos (meaning “correct”, “straight”) in 1741 by Nicholas Andry from which our specialty gets its name [4]. …