Factors Affecting the Results of Proximal Tibia Opening Wedge Osteotomy / 대한정형외과학회잡지

ABSTRACT

PURPOSE: This study sought to perform proximal tibia opening wedge osteotomy on osteoarthritis patients, assess the treatment and identify factors affecting clinical results. MATERIALS AND METHODS: Nineteen patients (19 cases) who had opening wedge osteotomy at our hospital from November 1987 to 1998, and were followed up on for at least 2 years were enrolled in the study. The follow-up period ranged from 2 years to 10 years 4 months averaging 5.3 years. We analyzed those factors that affected the results of operation, such as age, weight, joint space nar-rowing and corrective angle. RESULTS: Preoperative mean varus angle was 6.8 degrees and postoperative mean valgus angle 6.8 degrees. Mean valgus angle was degrees at the final follow-up. Clinical assessment of the patients following the final follow-up showed excellent in 8 cases, good cases, and fair in 2 cases. In addition, the remaining one case, assessed as poor, received total knee arthroplasty. The postoperative score was 86.3 +/-10.6 in the lower age group, and 82.4 +/-8.8 in the higher age group (p>0.05). The postoperative knee score was 89.2 5.2 in the non-obesity group, and 78.0 +/-11.0 in the obesity group (p<0.1). In relation to Ahlback classification, the postoperative score was 88.3 +/-5.0 in the stage I group and 70.0 +/-9.9 in stage II group (p<0.05). The postoperative knee scores were 77.3 +/-10.8, +/-8.0 and 91.0 +/-5.3, for those with postoperative valgus angles of below 5 degrees, 6 to 7 degrees, and over 8 degrees, respectively (p<0.05). CONCLUSION: We conclude that opening wedge osteotomy with overcorrection of the postoperative valgus angle may be an effective method in osteoarthritic patients with a mild loss of joint space.