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The Journal of Bone and Joint Surgery, Vol 70, Issue 7 977-982, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
Proximal tibial osteotomy in patients who are fifty years old or less. A long-term follow-up study
DL Holden, SL James, RL Larson and DB Slocum
Orthopaedic and Fracture Clinic, Eugene, Oregon 97401.
Proximal tibial valgus osteotomy was performed for unicompartmental
osteoarthritis in forty-five patients (fifty-one knees). The average age of
the patients was forty-one years (range, twenty-three to fifty years), and
the average length of follow-up was ten years. At follow-up, 70 per cent
(thirty-six knees) were rated as good or excellent and 30 per cent (fifteen
knees) were rated as fair or poor. There was no clear correlation between
the quality of the result and the radiographic evidence of the severity of
the arthritis preoperatively, the age of the patient at osteotomy, or the
length of follow-up. There was a correlation between an improved result and
an increased angle of correction after osteotomy, but the values were not
statistically significant. The most important factor influencing the
quality of results was the over-all level of disease in the knee as
reflected in the preoperative knee score. Deficiency of the anterior
cruciate ligament at the time of the osteotomy did not prevent a good
result. We believe that proximal tibial osteotomy for unicompartmental
arthritis of the knee is a good and effective procedure for patients who
are less than fifty years old and who have an active life-style, and that
lasting results can be achieved if the procedure is done early in the
course of the disease.

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