The medial opening-wedge high tibial osteotomy : novel insights in patient selection, preoperative planning, surgical precision and rehabilitation
Year after year, the global population and average life expectancy continues to grow, which is associated with a higher prevalence of degenerative orthopaedic pathologies. The knee and hip joint are most commonly and severely involved due to their weight-bearing function, leading to symptomatic wear of the cartilage or osteoarthritis (OA). Regarding knee OA, isolated cartilage wear of the medial compartment forms the most common subtype. Progression of medial knee OA is associated with increasing varus malalignment (bow legs) of the lower limb leading to overload in the medial compartment. If this pathology becomes symptomatic in the young and active patient, and persists after conservative management, a corrective osteotomy around the knee is preferred to restore the alignment of the lower limb. The corrective osteotomy can either be performed at the level of the tibia, the femur or both, depending on the origin of deformity and the magnitude of varus. The medial opening-wedge high tibial osteotomy (MOWHTO) is the most commonly performed osteotomy technique in daily orthopaedic practice. During this procedure, an osteotomy is created on the medial side of the proximal tibia after which the distal tibia is gradually translated towards lateral. As such, the overall lower limb alignment will be restored and the medial diseased compartment will be unloaded during weight-bearing and functional activities. Even though, this procedure has been successfully described for the first time by Jackson et al. in 1969 (‘High tibial osteotomy for osteoarthritis of the knee’), several scientific gaps in knowledge are present in today’s literature. This PhD thesis starts by formulating 7 critical research questions regarding patient selection, surgical planning and accuracy and early rehabilitation after MOWHTO. A chronologic structure containing 5 chapters is provided, equalizing the clinical pathway of the osteotomy patient.
Antwerp : University of Antwerp, Faculty of Medicine and Health sciences, Department of orthopaedic surgery , 2023
194 p.
Supervisor: Michielsen, Jozef [Supervisor]
Supervisor: Verdonk, Peter [Supervisor]
Supervisor: Claes, Steven [Supervisor]
Supervisor: Somville, Johan [Supervisor]
Full text (open access)
Research group
Publication type
Publications with a UAntwerp address
External links
Creation 09.11.2023
Last edited 21.11.2023
To cite this reference