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The Journal of Bone and Joint Surgery, Vol 69, Issue 1 32-38, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee
MB Coventry
From 1960 through 1979, a closing-wedge varus osteotomy of the proximal
part of the tibia was performed in thirty-one knees (twenty-eight patients)
for painful osteoarthritis of the lateral compartment of the knee that was
associated with a valgus deformity. The patients were followed for two to
seventeen years (average, 9.4 years). Twenty-four knees (77 per cent) had
either no pain or only occasional mild pain at the last evaluation. Six
knees had moderate pain and one, severe pain. Six knees required a
subsequent total knee arthroplasty at an average of 9.8 years after the
osteotomy. No patient had an infection or non-union. Osteotomy of the
proximal part of the tibia is a reasonable method of treating
unicompartmental degenerative arthritis in a knee with a valgus deformity.
Although some patients with as much as 20 degrees of anatomical valgus
deformity obtained a good result in this series, osteotomy in the
supracondylar region of the femur is probably preferable if the valgus
angulation exceeds 12 degrees or if the tilt of the tibial articular
surface that will result from the surgery will exceed 10 degrees.
Correction beyond the normal 5 to 7 degrees of valgus angulation to zero
degree of anatomical tibiofemoral alignment is recommended to prevent
recurrence of the valgus deformity and to decrease the load on the lateral
tibiofemoral compartment.
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