Medium- and long-term results of high tibial osteotomy for varus gonarthrosis in an agricultural population.
High tibial valgus osteotomy for varus gonarthrosis was performed in 63 consecutive patients in a homogenous agricultural population using two different surgical techniques. Patients were divided into two groups. A two-level Mittelmeier osteotomy was performed in group A patients, and a lateral closed wedge high tibial osteotomy using the AO/ASIF L-plate was performed in group B patients. Operations were performed by two different groups of surgeons. Patients were evaluated postoperatively for correction of knee axis, functional result, subjective impression, and complications. In group A patients, 80% of the operated knees were corrected to the mechanical axis and in group B patients, 82% of the knees were corrected to 6 degrees-10 degrees valgus of the anatomical axis. Ninety percent, 70%, and 54% of group A and 91%, 73%, and 57% of group B patients were rated as satisfactory results at 5, 9, and 12 years postoperatively, respectively; these differences were not statistically significant. One year postoperatively, 91% of group A and 96% of group B patients reported their symptoms had improved. However, patient satisfaction decreased at 5, 7, and 12 years postoperatively, with 91%, 89%, and 66% of group A and 96%, 93%, and 68%, respectively, of group B patients reporting their symptoms had improved; these differences were not statistically significant. Postoperatively, most patients returned to full agricultural activity. Total knee arthroplasty, which was later required in 12% of the knees, was not significantly jeopardized by the previous osteotomy.
Korovessis
P
P
Orthopedic Department, General Hospital, Agios Andreas Patras, Greece.
Katsoudas
G
G
Salonikides
P
P
Stamatakis
M
M
Baikousis
A
A
D000203:Activities of Daily Living; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016019:Survival Analysis; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome