オカザキ　ケン   Okazaki Ken   岡崎　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	総説
言語種別	英語
査読の有無	査読あり
招待の有無	招待あり
表題	Tibial condylar valgus osteotomy - indications and technique.
掲載誌名	正式名：Journal of experimental orthopaedics 略　 称：J Exp Orthop ISSNコード：21971153/21971153
掲載区分	国外
巻・号・頁	7(1),pp.30
著者・共著者	Kuwashima Umito, Yonekura Akihiko, Itoh Masafumi, Itou Junya, Okazaki Ken
担当区分	最終著者
発行年月	2020/05
概要	PURPOSE:To describe the indications for, and surgical technique of, tibial condylar valgus osteotomy (TCVO).INDICATIONS:TCVO is commonly performed in patients with middle-to-end-stage medial unicompartmental osteoarthritis. Among the most important TCVO indication criteria are the types of tibial plateau shape. The convex-type (also called "pagoda-type"), with over a 5° joint line convergence angle on the standing X-ray, meets the indication criteria for TCVO.SURGICAL TECHNIQUE:An L-shaped osteotomy is performed from the medial side of the proximal tibia to the lateral beak of the intercondylar eminence. The apex of the L-shaped osteotomy line is on the medial border of the patellar tendon insertion. Surgeons should note the direction of the chisel (during the osteotomy) to the intercondylar eminence following fluoroscopic guidance. The posterior cortical bone is cut under a lateral view observation, and the crossed-leg position is adopted to prevent injury to the popliteal blood vessels. The spreader should be positioned at the posterior cortical bone to avoid increasing the tibial slope. The locking plate reliably stabilizes the osteotomy and helps shorten the period of postoperative rehabilitation.CONCLUSIONS:TCVO adjusts varus deformity alongside joint congruity. Accurate identification of indications and a detailed surgical plan would ensure effective correction and proper alignment. Additional osteotomies are recommended in case of under-correction of the varus limb deformity. TCVO is an effective intervention in patients with advanced knee osteoarthritis and lateral joint laxity with the pagoda-type tibial plateau shape.
DOI	10.1186/s40634-020-00247-5
PMID	32405777