This report summarises a significant consensus statement from the UK Knee Osteotomy Consensus Group (KOG), a collection of leading surgeons and scientists. The group has produced 20 key recommendations to standardise the practice of osteotomy around the knee, with the goal of enhancing outcomes for patients. The guidelines cover a broad spectrum of the procedure, from initial patient selection to postoperative recovery.
Key Recommendations from the Consensus
The KOG’s recommendations are designed to provide a clear, evidence-based roadmap for orthopaedic surgeons. They acknowledge that while knee osteotomies have been performed for many years, a lack of standardisation has sometimes led to inconsistent results. This consensus aims to address that issue directly.
The recommendations cover:
- Indications for Surgery: Clear criteria for patient selection, considering factors beyond just age, such as physiological health, activity level, and the patient’s individual deformity.
- Preoperative Planning: Emphasising the critical need for meticulous planning, using modern imaging and measurement techniques to ensure the surgical correction is precise and tailored to the patient’s anatomy.
- Surgical Techniques: Guidance on the most effective surgical methods, including the use of bone graft augmentation in open wedge high tibial osteotomy (HTO) to support healing and improve stability.
- Postoperative Care: Best practices for recovery protocols and long-term assessment, including early mobilisation and pain management strategies.
- Decision-Making: A framework for choosing between an HTO and a unicondylar prosthesis (UKP), providing criteria that take into account the unique characteristics of each case to ensure the most appropriate treatment is selected.
Why This Consensus Matters
This consensus statement is a pivotal step for orthopaedic surgery in the UK, as it brings together the collective expertise of a dedicated group to refine and validate surgical practices. By providing clear guidance on patient selection, planning, and technique, the KOG aims to improve the consistency and predictability of knee osteotomy results. This, in turn, helps to build greater confidence among both surgeons and patients in the procedure as a viable option for joint preservation and long-term joint health.
The statement reinforces that when performed with a thorough understanding of the principles and a meticulous approach, knee osteotomy remains a highly valuable procedure for treating knee deformities and degenerative diseases.
Professor Wilson’s Comments
“I was very proud to work alongside some truly great friends as part of the ESSKA Osteotomy Consensus Group. We formed the ESSKA Osteotomy Committee, which I co-chaired for several years. Through this committee, we organised osteotomy courses around the world and delivered Instructional Course Lectures (ICLs) each year at the ESSKA Congress.
The very first ESSKA Osteotomy ICL took place in Amsterdam in 2014. We were given a relatively small room, but hundreds of people turned up—so many that someone actually fainted because it was so hot and overcrowded. It was during that meeting that Kristian Kley and I really connected for the first time, and from that moment, the rest is history.
Together, we helped grow the ESSKA Osteotomy Committee, bringing in friends and colleagues from across the world. Over the years, we built an international programme of lectures, workshops, and consensus work—culminating in the ESSKA Osteotomy Consensus, which we presented at the ESSKA Congress in Paris in 2022.
At that meeting, we delivered two or three major consensus documents, and our work was honoured with the award for Best Consensus Paper. This paper is one of several we subsequently published to provide surgeons with practical guidance on osteotomy surgery—covering indications, pre-operative planning, surgical execution, technical tips and tricks, postoperative care, and complication management.
We are all extremely proud of this collective effort, which represents years of collaboration and has now become the definitive global reference for modern osteotomy surgery.”
For a comprehensive overview of the full data, methodology, and in-depth analysis, the full research paper is available for your perusal.
Sources used in report overview:
- https://pubmed.ncbi.nlm.nih.gov/34562741/
- https://www.researchgate.net/publication/354783793_A_2021_consensus_statement_on_osteotomies_around_the_knee_by_the_UK_Knee_Osteotomy_consensus_Group_KOG
- https://www.ukkor.co.uk/
