Prospective Register for Osteotomies around the Knee

Corrective osteotomies around the knee allow for the treatment of different deformities of the lower extremities. At Balgrist University Hospital, patients treated with such osteotomies are prospectively registered for assessment of clinical and radiological outcomes with the aim of continuous improvement of orthopedic surgery.

Corrective osteotomies rank among the historic and modern cornerstones in orthopedic surgery. In most hospitals performing osteotomies around the knee, the preoperative planning relies on conventional two-dimensional (2D) radiographs, and the surgical execution is performed using a free-hand technique referring to the 2D planning. At Balgrist University Hospital, we have the advantage of having a team of engineers (Computer Assisted Research and Development Group (CARD)) focusing on preoperative three-dimensional (3D) planning and the design of patient-specific instruments (PSI), which allow for the transfer of the preoperative planning into the intraoperative situation. This close cooperation between clinicians and engineers does not only improves patient care, but also has the advantage of creating meticulous documentation of all osteotomies, which then is transferred into our knee osteotomy register.

Nowadays, one of the most common indications in adult patients for corrective osteotomy around the knee is a symptomatic unbalanced load distribution in the knee due to varus or valgus deformity. Different studies regarding varus and valgus osteotomies around the knee, using our knee osteotomy register data, have already been published in internationally renowned journals. One of these studies investigated the accuracy of high tibial osteotomy using PSI. This study was even honored by The European Society of Sports Traumatology, Knee Surgery & Arthroscopy (ESSKA) with the “JEO Best Paper Award 2020 – 2021”. Patellofemoral instability is another indication that often necessitates an osteotomy around the knee. Aff ected patients may suffer from torsional deformities of the femur and the tibia, requiring a torsional osteotomy. The 3D analysis that is routinely perfomed at Balgrist University Hospital results in a signifi cantly improved understanding and preoperative planning in such complex deformities. Using our knee osteotomy register data, different studies on osteotomies in patellofemoral instability have already been published in international renowned journals. One of these studies investigated the combined correction of tibial torsion and the misalignment of the extensor mechanism by a special developed tibial rotational osteotomy. The Swiss Orthopaedics honored this study with the “Venel Prize 2021 in Clinical Research”.