title: Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results.
abstract: OBJECTIVE
  Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure.
  
  
  METHODS
  11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated.
  
  
  RESULTS
  The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure.
  
  
  CONCLUSIONS
  Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.
authors.affiliation: Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. kohchiba@estate.ocn.ne.jp.
authors.forename: Ko
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yonekura
authors.affiliation: Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Osaki
authors.affiliation: Department of Orthopaedic Surgery, Nishi-Isahaya Hospital, 3015 Kaizu, Isahaya, Nagasaki, 854-0063, Japan.
authors.forename: Goji
authors.initials: G
authors.lastname: Chiba
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001860:Bone Plates; D004434:Early Ambulation; D005260:Female; D056304:Genu Valgum / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009864:Ontario; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011859:Radiography; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: High tibial osteotomy; Osteoarthritis of the knee; Tibial condylar valgus osteotomy