Treating the Younger Degenerative Knee From Osteotomy to Arthroplasty (AANA22)-Offload It! Osteotomy for Arthritis

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Video Summary

This talk focuses on osteotomy as an effective offloading solution for arthritis, particularly medial arthritis, emphasizing its role in restoring joint alignment and preserving joint homeostasis. Unlike arthroplasty, osteotomies act as bridging procedures that can offer excellent outcomes for a decade or more, especially in younger, active patients with ligament instability, cartilage defects, or meniscal pathology. Key points include patient selection criteria, surgical techniques (medial opening vs. lateral closing wedges), and avoiding complications through meticulous preoperative planning and exposure familiarity. The presenter highlights the learning curve—typically performing 50-60 osteotomies annually—and advocates for the integration of patient-specific instrumentation to improve accuracy and reduce operative time. Postoperatively, patients can often return to high-level activities gradually after bone healing, with counseling on realistic expectations. The overall message underscores osteotomy as a valuable, joint-preserving option tailored by precise alignment correction and individual patient goals, aiming to maintain active lifestyles before potential future surgeries.

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Seth L. Sherman, M.D

Keywords

osteotomy

medial arthritis

joint alignment

patient selection

surgical techniques

patient-specific instrumentation