Ten-year results of tibial osteotomy for medial gonarthrosis

Odenbring, Sten; Egund, Niels; Hagstedt, Bengt; Larsson, Jan; Lindstrand, Anders; Toksvig‐Larsen, Sören

doi:10.1007/bf00393883

Cited by 56 publications

(35 citation statements)

References 26 publications

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“…Therefore, in the present series we only aimed at a slight overcorrection. As reported by other authors, however, the smaller load reduction thus led to poorer long-term results [3,8,13,17].…”

Section: Discussionmentioning

confidence: 69%

High tibial osteotomy for valgus and varus deformities of the knee

Leutloff

Tobian

Perka

2001

International Orthopaedics (SICOT)

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In 53 patients with a mean age of 38 (17-73) years, 71 high tibial osteotomies were performed. Twenty-three patients had no radiological signs of osteoarthrosis (Ahlbäck grade 0), whereas 26 patients had primary and 22 patients secondary osteoarthritis. Follow-up was 10.5 (5.8-16.6) years. The patients without radiological osteoarthrosis achieved almost exclusively good or very good scores using the Lysholm-Gillquist (96%) and the Insall scale (83%). By contrast, only 29% of the patients with radiological osteoarthritis achieved good or very good scores. Whether the patient had primary or secondary osteoarthrosis was of no influence. Neither was the preoperative axial deviation.Résumé Chez 53 patients, d'âge moyen 38 (17-73) ans, 71 ostéotomies hautes du tibia ont été éffectuées. Vingttrois malades n'avaient pas de signes radiologiques d'arthrose (Ahlbäck grade 0), alors que 26 malades avaient une arthrose primaire et 22 une arthrose secondaire. Le suivi était de 10.5 (5.8-16.6) années. Les malades sans arthrose radiologique ont atteints presque exclusivement des bons ou très bons scores selon les échelles de Lysholm-Gillquist (96%) et d' Insall (83%). Par contraste, seulement 29% des malades avec arthrose radiologique ont atteints de bons ou très bons scores. Le caractère primaire ou secondaire de l'arthrose et la déviation axiale préopératoire n'avaient aucune influence.

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Section: Discussionmentioning

confidence: 69%

High tibial osteotomy for valgus and varus deformities of the knee

Leutloff

Tobian

Perka

2001

International Orthopaedics (SICOT)

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“…14 High tibial osteotomy is an excellent alternative, 15,16 but may compromise a subsequent TKA, should the osteotomy fail. To assess micromotion, we used RSA, which has been shown to be sensitive in assessing fixation of the tibial component.…”

Section: Discussionmentioning

confidence: 99%

“…15 The need for conversion of a failed osteotomy to an arthroplasty is diminishing, 18 indicating an improvement in operative technique. We did encounter some more, but not significant, revisions of the prosthesis after total arthroplasty following upper tibial osteotomy, but two of these patients pursued very active occupations.…”

Section: Hka Pt Ptsmentioning

confidence: 99%

Fixation of the tibial component of total knee arthroplasty after high tibial osteotomy

Magyar

Önsten

Ryd

et al. 1998

The Journal of Bone and Joint Surgery. British volume

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T o assess migration of the tibial component we used roentgen stereophotogrammetric analysis in 40 patients who had had a total knee arthroplasty after failure of a closing wedge osteotomy and compared them with 40 matched patients after primary total knee arthroplasty.We found no difference in migration over time or in the tendency for continuous migration between the two groups. There were no differences in alignment or position of the knee prosthesis or in the clinical outcome.Our findings show that revision of a failed high tibial osteotomy to a total knee arthroplasty is effective.

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“…The latter relieves pain effectively in arthritis of the medial compartment. [3][4][5]8,9 Slight overcorrection of the mechanical axis gives the best long-term results, diminishing both the risk of recurrence of varus deformity and the need for revision surgery. The disadvantage of HTO is that it is technically demanding and calls for a long period of rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee

Magyar¹,

Ahl

Vibe

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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Medial osteoarthritis of the knee is associated with varus deformity and an abnormal load through the medial compartment. Proximal tibial osteotomy can restore the mechanical axis and correct the abnormal load.1,2 Good long-term results depend on the ultimate correction, which is ideally 2° to 8° of valgus of the mechanical axis. [3][4][5][6] There are several reports of good results achieved by closedwedge osteotomy, 3-5,7-9 but this procedure is technically demanding. The outcome is unpredictable and the period of convalescence lengthy. 7,9-11 In addition, access to the lateral compartment may be difficult after previous tibial osteotomy, 12,13 and even in the younger age group some surgeons carry out a primary arthroplasty rather than an osteotomy. 14-16 Open-wedge osteotomy by hemicallotasis (HCO) is simpler and requires a shorter rehabilitation period. 17,18We have compared in a randomised, prospective study the results and complications of closed-wedge high tibial osteotomy (HTO) and HCO. Patients and MethodsWe randomly allocated 46 patients (14 women and 32 men) to either HTO (n = 25) or HCO (n=25). The two groups were similar in age, gender, preoperative grade of arthritis and hip-knee-ankle angle (HKA) ( Table I). The median age was 55 years (40 to 68) in the HTO group and 55 years (38 to 64) in the HCO group. The median range of movement was 125° (105 to 140) in the HTO group and 130° (90 to 150) in the HCO group. Bilateral surgery was carried out on four patients, one of whom was randomised to HTO on both sides. The other three had HTO on one side and HCO on the other. There was a median interval of nine months (2.5 to 14) between the two operations. Surgeons of equal experience and skill carried out the procedures.The indication for surgery was pain in younger, active patients with medial arthritis of grade 1 to 3. 19 We aimed to achieve an overcorrection to an HKA of 4° of valgus in both groups. The correction of 4 ± 2° of valgus was considered optimal.

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Ten-year results of tibial osteotomy for medial gonarthrosis

Cited by 56 publications

References 26 publications

High tibial osteotomy for valgus and varus deformities of the knee

High tibial osteotomy for valgus and varus deformities of the knee

Fixation of the tibial component of total knee arthroplasty after high tibial osteotomy

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee

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