Late recurrence of varus deformity after proximal tibial osteotomy.
One hundred thirteen knees with medial gonarthrosis in 95 patients were treated by valgus-producing proximal tibial osteotomy and followed clinically and roentgenographically for a minimum of five years (mean, 6.3 years). Sixty-four knees (57%) were pain free or had only mild discomfort when walking. The standing femorotibial angle decreased from a postoperative average of 9.3 degrees valgus to 7.8 degrees valgus at the final follow-up examination. The tendency for varus recurrence greater than 5 degrees and for medial- or lateral-compartment arthritic progression was evaluated using the Kaplan-Meier survival method. Varus recurred in 18%, lateral-compartment arthritic progression in 60%, and medial-compartment arthritic progression in 83% by nine years after surgery. The probability of arthritic progression is much higher than the probability of significant varus recurrence in long-term roentgenographic follow-up studies of patients with valgus-producing proximal tibial osteotomies.
Stuart
M J
MJ
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.
Grace
J N
JN
Ilstrup
D M
DM
Kelly
C M
CM
Adams
R A
RA
Morrey
B F
BF
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011336:Probability; D011859:Radiography; D012008:Recurrence; D016019:Survival Analysis; D013977:Tibia / Q000601:surgery*