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The Journal of Bone and Joint Surgery, Vol 67, Issue 8 1188-1194, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
A relationship between gait and clinical changes following high tibial osteotomy
CC Prodromos, TP Andriacchi and JO Galante
We studied the cases of twenty-one patients with high tibial osteotomy in
order to determine the relationship between knee-joint loading during gait
and clinical outcome. The patients were tested before surgery, one year
after surgery, and again at an average of 3.2 years after surgery. An
age-matched group of fifteen control subjects was also studied. The results
of this study indicate that certain characteristics of preoperative walking
are associated with postoperative clinical results. In particular, the
moment tending to adduct the knee joint during walking preoperatively was
predictive of postoperative clinical results. The patients were classified
into a high adduction-moment group and a low adduction-moment group
according to the magnitude of the knee-adduction moment. The adduction
moment was reduced in both groups after high tibial osteotomy. However, the
average postoperative adduction moments in the low adduction-moment group
were still significantly lower than those in the high adduction-moment
group. The two groups were indistinguishable on the basis of preoperative
knee score, initial varus deformity, immediate postoperative correction,
age, and weight. However, at an average 3.2-year follow-up, patients with
low preoperative adduction moments had substantially better clinical
results than did patients with high adduction moments. The low
adduction-moment group had 100 per cent excellent or good clinical results,
while only 50 per cent of the patients in the high adduction-moment group
had an excellent or good result. Furthermore, there was a significant
recurrence of varus deformity in the patients in the high adduction-moment
group.(ABSTRACT TRUNCATED AT 250 WORDS)
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