title: A 12-28-year followup study of closing wedge high tibial osteotomy.
abstract: Current indications for high tibial osteotomy (HTO) are controversial although several risk factors have been associated with HTO survival. We ascertained the influence of preoperative variables in a consecutive series of patients who had closing wedge HTO at a minimum of 12 year followup (mean 18-year, range 12 to 28 years). Three hundred one of an initial 372 high tibial osteotomies (313 patients) were included (81% followup); 71 knees were eliminated because patients died (30 knees) or were lost to followup (41 knees). The mean age was 42 years (range, 15-76 years), 194 were men and 119 were women. The osteotomy was fixed by a Blount staple and an AO half-tube plate with three screws. Forty-three knees (14%) in 39 patients were revised for progression of osteoarthritis at an average of 102 months. Survival was 85% at 20 years with revision as the endpoint. Knee function was considered satisfactory by 77% of patients. At final followup, 1/2 of the knees showed radiographic signs of medial osteoarthritis. The most important risk factors predicting revision were age greater than 50 years and a preoperative arthritis Ahlback grade of 3 or more.
authors.affiliation: Aix-Marseille University, Department of Orthopedic Surgery, Hôpital Sainte-Marguerite, Marseille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Flecher
authors.forename: Sebastien
authors.initials: S
authors.lastname: Parratte
authors.forename: Jean-Manuel
authors.initials: JM
authors.lastname: Aubaniac
authors.forename: Jean-Noël A
authors.initials: JN
authors.lastname: Argenson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D013997:Time Factors