Survivorship of lateral closing wedge proximal tibial osteotomy / 中国矫形外科杂志

ABSTRACT

[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7～9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°～15°.