osteotomy

Management

Management Summary

 

Stage 0

 

Natural history mixed

- depends on size of lesion and diagnosis

- treat if becomes asymptomatic

- may benefit from bisphosphonates

 

Stage 1 / Normal X-ray, abnormal MRI

 

Forage: 80% G/E

Bisphosphonates

 

Stage 2 / Abnormal X-ray with cysts and sclerosis

 

A:  As for Stage I

Extra-articular Deformity

Causes of Deformity

 

Metabolic Bone Disease

Paget's

Fracture Malunion

Previous Osteotomy

 

Options

 

1.  Intra-articular correction

2.  Simultaneous osteotomy and TKR

3.  Staged correction and TKR

 

1.  Intra-articular correction 

 

Indications

 

Femur

- draw line of mechanical axis of femur

Insertional Achilles Tendinopathy

Definition

 

Inflammation of achilles tendon; insertional or noninsertional

 

Spectrum

 

Tendonitis / Tendonosis / Rupture

 

Anatomy

 

Triceps surae

- medial and lateral gastrocnemius

- soleus

- surrounded by paratenon which allows gliding and supplies nutrition

 

Inserts middle 1/3 calcaneal tuberosity

- 2 x 2 cm area

- 90o rotation distally

 

Retrocalcaneal bursa (x2)