[Predictors of tibial head transposition in the therapy of varus knee osteoarthritis].
OBJECTIVE
The aim of this study was to find predictors for the clinical outcome in patients who underwent a high tibial osteotomy (HTO).


METHODS
Between 1984 and 1996 a high tibial valgus osteotomy was performed in 155 patients with genu varum. 133 HTO patients were available for follow-up at an average postoperative time of 9.3 +/- 3.0 years. The degree of osteoarthritis was evaluated by radiological (Kellgren) and arthroscopic scoring systems (Outerbridge). Survival time of HTO was estimated using Kaplan-Meier survivorship analysis.


RESULTS
The survival rate of HTO was 95 % after 5 years and 77 % after 10 years. In the medial compartment of knee joints with a preoperative Outerbridge stage III/IV or Kellgren stage III/IV the survival rate of HTO was significantly lower when compared to stages 0/I/II (p < 0.05). Age, sex, tibial malalignment and severity of osteoarthritis in the lateral compartment had no influence on survival rates. The pre-postoperative comparison of radiologically visible signs of osteoarthritis showed mainly either no (46.5 %) or only small (50.5 %) progression. We found that patients who underwent a HTO had good and very good clinical outcomes.


CONCLUSIONS
We identified severity of preoperative radiological osteoarthritis and intraoperative chondromalacia as predictors of survival rate.
Gall
N
N
Orthopädische Klinik mit Querschnittgelähmtenzentrum der Universität Ulm.
Fickert
S
S
Puhl
W
W
Günther
K P
KP
Stöve
J
J
D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013977:Tibia / Q000002:abnormalities / Q000601:surgery; D016896:Treatment Outcome