Peri-knee osteotomy for treatment of knee osteoarthritis:optimization of treatment strategies

Chen Qiuhan; Yang Long; Yuan Daizhu; Wu Zhanyu; Zou Zihao; Ye Chuan

doi:10.12307/2026.586

Abstract：BACKGROUND:With the rise of knee-preserving concepts,peri-knee osteotomy has gradually become an important method for treating early-to mid-stage knee osteoarthritis due to its advantages in correcting lower limb alignment,reducing joint load,and delaying the need for joint replacement. OBJECTIVE:To summarize the advantages,disadvantages,and clinical outcomes of various knee osteotomy techniques,providing a reference for developing appropriate surgical strategies in clinical practice. METHODS:The PubMed and CNKI from 2014 to 2024 were searched for relevant literature on peri-knee osteotomy for the treatment of knee osteoarthritis.The Chinese and English search terms included"knee osteoarthritis,high tibial osteotomy,distal femur osteotomy,proximal fibula osteotomy,tibial condylar valgus osteotomy,dome shaped high tibial osteotomy,limb alignment correction,joint-preserving surgery."Following inclusion and exclusion criteria,108 articles were ultimately included for this review. RESULTS AND CONCLUSION:(1)The effectiveness of peri-knee osteotomy in the treatment of knee osteoarthritis has been widely recognized.In recent years,the clinical outcomes have significantly improved through the optimization of various surgical techniques,including high tibial osteotomy,distal femoral osteotomy,proximal fibular osteotomy,and the innovative popliteus anterior high tibial tubercle osteotomy.(2)These procedures effectively alleviate pain and improve functional activity by correcting lower limb alignment and optimizing weight distribution across the knee joint.However,postoperative complications such as lateral hinge fractures,patella baja,and insufficient correction remain concerns.With the development of personalized osteotomy plans,the precision and safety of the surgery have been further enhanced through comprehensive assessment of the patient's age,deformity origin,and underlying conditions.In conclusion,peri-knee osteotomy plays a crucial role in improving knee function and enhancing patients'quality of life.