The Journal of Bone and Joint Surgery, Vol 63, Issue 6 938-946, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Tibial osteotomy for osteoarthritis of the knee. A five to ten-year follow-up study
S Vainionpaa, E Laike, P Kirves and P Tiusanen
Of the 141 osteoarthritic knees treated by tibial osteotomy at the Kotka
Central Hospital from 1969 to 1974, 103 (ninety-two with a varus deformity
and eleven with normal alignment) were followed for at least five years,
the average follow-up being 6.9 years. In eighty-six knees (83.5 per cent)
the result was good or fair. In the ninety-two knees with a varus
deformity, the best results were achieved when the postoperative
femorotibial angle was 167 to 175 degrees. In the eleven knees with normal
preoperative alignment, the osteotomy was designed to shift the load to the
compartment in which there was less osteoarthritis involvement. In nine of
these eleven knees there was an average change in angulation (varus or
valgus) of 5.3 degrees (range, 3 to 9 degrees) and the result was good or
fair. All osteotomies united without reoperation. The incidence of delayed
union was 3.6 per cent when the osteotomy was proximal and 14 per cent when
it was distal to the tibial tubercle. The elimination of the tethering
effect of the fibula by osteotomy or release of the proximal tibiofibular
joint did not prevent the recurrence of varus deformity. At an average of
3.4 years after the osteotomy, deterioration was demonstrable in twenty-six
knees in which the initial result had been good. This is a higher incidence
of deterioration than in previously published series. In sixteen of the 103
knees, a total arthroplasty subsequently was performed because of a poor
result, at an average of 7.6 years after the osteotomy.
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