Osteotomy around young deformed knees: 38-year super-long-term follow-up to detect osteoarthritis.
Since 1969 corrective osteotomy has been performed at our institute in young patients (under 40 years) with bowlegs, knock knees and flexion or rotational deformities around the knee. Fifty-seven knees (29 left, 28 right) of 45 patients (19 boys, 26 girls) were followed-up for a period ranging from 30 to 38 years in seven patients with seven knees, from 20 to 29 years in nine patients with 11 knees, and from ten to 19 years in 29 patients with 39 knees. Supracondylar femoral osteotomy was performed on 12 knees (11 patients), high tibial osteotomy above the tibial tuberosity on eight knees (six patients) and below the tuberosity on 37 knees (28 patients). At the final follow-up (age range 42-73 years), all of the deformities were satisfactorily corrected, with no symptoms apart from nine knees, seven of which had dull pain after strenuous sport with osteophytes, etc. in the radiograph. Total knee arthroplasty was performed in the remaining two knees, at ten and 26 years, respectively, after the initial osteotomy. Osteoarthritis developed in the contralateral knee to the initial osteotomy in two patients after 34 years at age 73 and after 33 years at age 67.
Department of Orthopaedic Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan. koshino@med.yokohama-cu.ac.jp
Tomihisa
T
Koshino
D000293:Adolescent; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee; D017760:Bone Malalignment / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D007592:Joint Diseases / Q000151:congenital / Q000453:epidemiology / Q000601:surgery*; D007719:Knee Joint / Q000002:abnormalities / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation / Q000379:methods; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult