Osteotomy for Unicompartmental Knee Osteoarthritis: Indications and Outcomes

Osteotomies are classically utilized in the treatment of unicompartmental knee osteoarthritis (OA) in young active patients as part of a joint preservation strategy. As unicompartmental knee OA is often associated with malalignment, the osteotomy procedure is designed to shift the patient's mechanical axis to neutral alignment. By shifting the mechanical axis, there is decreased contact pressures in the affected compartment providing both pain relief and offloading of the affected compartment. Osteotomies can be performed in the proximal tibia or distal femur depending on the location of deformity. Both procedures have demonstrated successful improvement in clinical and functional outcomes and a delay in progression to total knee arthroplasty. The use for osteotomy in the treatment of unicompartmental knee osteoarthritis and the outcomes associated with osteotomies are discussed in detail in this review.