Home > Journals > Minerva Ortopedica e Traumatologica > Past Issues > Minerva Ortopedica e Traumatologica 2010 August;61(4) > Minerva Ortopedica e Traumatologica 2010 August;61(4)343-52





A Journal on Orthopedics and Traumatology

Official Journal of the Piedmontese-Ligurian-Lombard Society of Orthopedics and Traumatology
Indexed/Abtracted in: EMBASE, Scopus, Emerging Sources Citation Index




Minerva Ortopedica e Traumatologica 2010 August;61(4)343-52

language: English

Tibial osteotomy in post-traumatic arthritis of the knee

Massin P., Deschamps G.

1 Orthopedic Surgery Department, CHU Bichat Claude Bernard, Paris, France.
2 Medico-Surgical center, Dracy le Fort, France


In post-traumatic arthritis of the knee, tibial osteotomy can be performed for 2 reasons: first for correcting a post-traumatic deformation, and second, for treating unicompartmental arthritis. Two bone sections may be required, but most often both goals can be reached with a single bone section. Usually, rotational deformities follow closed intra-medullary nailing of a diaphyseal fracture, while axial deformity results from complex tibial plateau fractures and may combine intra and extra-articular malunions. A three dimensional analysis of the deformation, based on long leg standing radiographs and a computed tomograohy (CT) scan, is mandatory. Axial deformities can be corrected in the upper metaphysis, while rotational deformities are better corrected in the lower metaphysis. A mild unicompartmental arthritis of the knee with an extra-capsular deformity of more than 10° in either plan is the best indication for a corrective osteotomy. If the degenerative changes are more severe, an associated arthroplasty should be considered in elderly patients. Upper tibial osteotomies are compatible with a simultaneous total knee replacement using the same approach. The treatment of intra-capsular deformities is more controversial. Intra-articular osteotomy should be considered in severe deformities in young patients. Osteotomies reproducing the traject of the initial separation-fracture are technically demanding, and will principally restore the articular profile. Extra-capsular osteotomies can be a useful adjunct. Unexpected satisfactory results may be obtained in young patients, which will allow delaying the prosthesis. In case of failure, total knee replacement will be facilitated.

top of page

Publication History

Cite this article as

Corresponding author e-mail