title: Load distribution in early osteoarthritis.
abstract: Total knee replacement is an accepted standard of care for the treatment of advanced knee osteoarthritis with good results in the vast majority of older patients. The use in younger and more active populations, however, remains controversial due to concerns over activity restrictions, implant survival, and patient satisfaction with the procedure. It is in these younger patient populations that alternatives to arthroplasty are increasingly being explored. Historically, osteotomy was utilized to address unicompartmental pain from degeneration and overload, for example, after meniscectomy. Utilization rates of osteotomy have fallen in recent years due to the increasing popularity of partial and total knee arthroplasty. This article explores the indications and outcomes of traditional unloading osteotomy, as well as newer options that are less invasive and offer faster return to function.
authors.affiliation: Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. agomoll@partners.org.
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Gomoll
authors.affiliation: Department of Trauma Surgery, University Medical Center Regensburg, Sporthopaedicum Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Angele
authors.affiliation: Department of Orthopedic and Traumatology, Sacro Cuore Hospital, Via Don Sempreboni, 5, 37024, Negrar, Verona, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Condello
authors.affiliation: Department of Orthopedic and Traumatology, Sacro Cuore Hospital, Via Don Sempreboni, 5, 37024, Negrar, Verona, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Madonna
authors.affiliation: Center of Experimental Orthopaedics, Department of Orthopaedic Surgery, Saarland University Medical Center, Saarland University, Kirrberger Strasse 100, Building 37-38, 66421, Homburg/Saar, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Madry
authors.affiliation: 2nd Department of Orthopaedics and Traumatology, IRCCS Policlinico San Donato, Milan, San Donato Milanese, Italy.|Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Randelli
authors.affiliation: Hospital of University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Nogah
authors.initials: N
authors.lastname: Shabshin
authors.affiliation: Department of Orthopaedics and Trauma, Jan Palfijn Ziekenhuis, 9000, Ghent, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Verdonk
authors.affiliation: Department of Orthopaedics and Trauma, Jan Palfijn Ziekenhuis, 9000, Ghent, Belgium.
authors.forename: Rene
authors.initials: R
authors.lastname: Verdonk
mesh_terms: D000367:Age Factors; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D061345:Early Medical Intervention; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Early OA; High tibial osteotomy; Knee osteoarthritis; Overloading