Tibiale umstellungsosteotomie am kniegelenk - Renaissance eines klassischen verfahrens?

Osteotomies around the knee joint are used to correct malalignment in cases of unicompartmental osteoarthritis. The corrections of the axis, which generally take place at the site of the malalignment, are frequently performed, according to the most common pathology, in the area of the proximal tibial head. Different fixation systems are available either for the laterally closing "closed-wedge" or the medially opening "open-wedge" technique. The high tibial osteotomy which can be performed together with other interventions such as anterior cruciate ligament reconstruction or meniscus replacement, represents also useful tool for exact correction of the tibial slope to change the antero-posterior translation forces. The value of the corrective osteotomy - a procedure with a relative operative risk for complications - is often discussed with regards to the improved quality of the unicompartmental knee joint prostheses. However, despite good results reported following unicompartmental joint replacement, corrective osteotomy around the knee joint remains an important alternative especially for young and active patients with limited osteoarthritis to significantly delay the time point of joint replacement.