[Treatment of lax arthrotic genu valgum using Debeyre's unicondylar osteotomy. A radioclinical study of 55 knees operated on more than 5 years ago].
Seventy-five cases of degenerative arthritis of the knee with laxity (Ahlback grade III, IV and V) were treated by unicondylar osteotomies of the femur performed between 1967 and 1980. 64 have been reviewed after more than five year follow-up. Among them, nine had been re-operated on because of early complications when this technique was set up. The fifty-five remaining knees were reviewed after a nine year average follow-up. Despite the severity of the joint involvement forty-four were still improved by the osteotomy. The tightening of the collateral ligaments had suppressed the joint laxity. The subluxation of the lateral femoro-tibial joint was reduced and the joint space was enlarged. Eleven knees had deteriorated after five years, seven times in the lateral compartment, four times in the medial one. Five had to be re-operated on, due to functional worsening. Good results were observed when the obtained angle was situated between 3 degrees valgus and 10 degrees varus. A persisting valgus more than 4 degrees may lead to a recurrence. Hypercorrection led to a worsening of the medial femoro-tibial joint in two cases. The unicondylar femoral osteotomy is worth-while even in severe degenerative arthritis. The technique must be precise to avoid failures. It is indicated in cases of joint laxity, extra articular osteotomies being indicated when the laxity is absent. It should not be proposed over the age of 70 years to avoid a risk of stiffness.
Goutallier
D
D
Service de Chirurgie Orthopédique. Hôpital Henri-Mondor, Créteil.
Hernigou
P
P
Lenoble
E
E
D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007719:Knee Joint; D010003:Osteoarthritis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy; D011859:Radiography
Traitement du genu valgum arthrosique laxe par l'ostéotomie unicondylienne de Debeyre. Etude radioclinique de 55 genoux opérés depuis plus de 5 ans.