When should osteotomy about the knee be chosen over total knee replacement?
Osteotomy is appropriate in the young, active patient with unicompartmental arthritis. The high tibial osteotomy is the most commonly performed realignment procedure for the knee with degenerative changes limited to either the medial or lateral compartment. Involvement of the patellofemoral compartment, inflammatory arthritis, marked loss of motion, and instability are contraindications. This procedure is usually intended to relieve pain, preserve functional status, and delay the need for a total knee replacement. The most common complications include under correction and peroneal nerve injury.