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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 October;50(5):169-76
Closing wedge high tibial osteotomy in varus knee: medium term results
Forti M., Nicodemo A., Seccia A., Pipino R.
Background. To date no unanimous agreement as to the indications, degree of correction and medium-long term results of high tibial valgisation osteotomy has been made. Aim of this study is to investigate in particular these aspects.
Methods. The time-dependent results in 68 cases (61 patiens) of closing wedge high tibial osteotomy were analyzed. The mean follow-up was 72 months (range 11-135). The following data were considered: age, Body Mass Index and other clinical parameters necessary to fill in a knee valutation form (''Knee Society Clinical Rating System''). A full-lenght anteroposterior single leg standing radiograph was also performed in order to estimate the angular deformity and the degree of gonarthritis. Clinical and radiological results were compared with preoperative data.
Results. Only 5 patients (7,4%) underwent a knee replacement, on average 92,2 months after the osteotomy (range 67-124). The excellent results were 20 (31,7%), good 18 (28,6%), fair 9 (14,3%), poor 16 (25,4%). The best results were observed in patients younger than 65, with a body mass index <27, preoperative gonarthritis <3 according to Ahlback scale, varism <10° and articular range >90° before surgery.
Conclusions. In the presence of these indications and of a careful therapeutic management, high tibial valgisation osteotomy still seems to have an important role in the therapy of gonarthritis.