Skip to main content

Long-term outcome after high tibial osteotomy

An Erratum to this article was published on 15 January 2008



The frequency of tibial osteotomy in the treatment of osteoarthritis of the knee has decreased due to the demanding surgical procedure and the rising number of total knee replacements (TKR). Only few data exist concerning survival rates after high tibial osteotomy (HTO) with a follow-up exceeding 10 years. We want to present long-term results with a follow-up of more than 18 years after operation.

Materials and Methods

Survival rates and the influence of age, gender and the mechanical axis were investigated in 134 lateral closing-wedge osteotomies in 111 patients.


The survival rate was 94% after 5 years, 79.9% after10 years, 65.5% after 15 years, and 54.1% after 18 years. Age had a significant influence on the survival and gender and the mechanical axis had no significant influence.


We conclude, that with a 54.1% survival after 18 years HTO is a useful facility to protract the implantation of a total knee prosthesis.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Aglietti P, Buzzi R, Vena LM, Baldini A, Mondaini A (2003) High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg 16(1):21–26

    PubMed  Google Scholar 

  2. Amendola A, Panarella L (2005) High tibial osteotomy for the treatment of unicompartmental arthritis of the knee. Review Orthop Clin North Am 36(4):497–504

    Article  Google Scholar 

  3. Bauer GC, Insall J, Koshino T (1969) Tibial osteotomy in gonarthrosis (osteo-arthritis of the knee). J Bone Joint Surg Am 51(8):1545–1563

    PubMed  CAS  Google Scholar 

  4. Biau D, Mullins MM, Judet T, Piriou P (2006) Is anyone too old for a total knee replacement? Clin Orthop Relat Res 448:180–184

    PubMed  CAS  Google Scholar 

  5. Billings A, Scott DF, Camargo MP, Hofmann AA (2000) High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion. Long-term follow-up. J Bone Joint Surg Am 82(1):70–79

    PubMed  CAS  Google Scholar 

  6. Cass JR, Bryan RS (1988) High tibial osteotomy. Clin Orthop Relat Res 230:196–199

    PubMed  Google Scholar 

  7. Coventry MB (1973) Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am 55(1):23–48

    PubMed  CAS  Google Scholar 

  8. Coventry MB (1985) Upper tibial osteotomy for osteoarthritis. J Bone Joint Surg Am 67(7):1136–1140

    PubMed  CAS  Google Scholar 

  9. Coventry MB (1987) Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee. J Bone Joint Surg Am 69(1):32–38

    PubMed  CAS  Google Scholar 

  10. Coventry MB, Ilstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy. A critical long-term study of eighty-seven cases. J Bone Joint Surg Am 75(2):196–201

    PubMed  CAS  Google Scholar 

  11. Healy WL, Iorio R (2007) Implant selection and cost for total joint arthroplasty: conflict between surgeons and hospitals. Clin Orthop Relat Res 457:57–63

    PubMed  Google Scholar 

  12. Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354

    PubMed  CAS  Google Scholar 

  13. Insall JN, Joseph DM, Msika C (1984) High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 66:1040–1048

    PubMed  CAS  Google Scholar 

  14. Ivarsson I, Myrnerts R, Gillquist J (1990) High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg Br 72(2):238–244

    PubMed  CAS  Google Scholar 

  15. Matthews LS, Goldstein SA, Malvitz TA, Katz BP, Kaufer H (1988) Proximal tibial osteotomy. Factors that influence the duration of satisfactory function. Clin Orthop Relat Res 229:193–200

    PubMed  Google Scholar 

  16. Naudie D, Bourne RB, Rorabeck CH,Bourne TJ (1999) Survivorship of the high tibial valgus osteotomy. Clin Orthop Relat Res 367:18–27

    PubMed  Article  Google Scholar 

  17. Ritter MA, Fechtman RA (1988) Proximal tibial osteotomy. A survivorship analysis. J Arthroplasty 3(4):309–311

    PubMed  Article  CAS  Google Scholar 

  18. Sprenger TR, Doerzbacher JF (2003) Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J Bone Joint Surg Am 85-A(3):469–474

    PubMed  Google Scholar 

  19. Tang WC, Henderson IJ (2005) High tibial osteotomy: long term survival analysis and patients`perspective. Knee 12(6):410–413

    PubMed  Article  Google Scholar 

  20. Trieb K, Grohs J, Hanslik-Schnabel B, Stulnig T, Panotopoulos J, Wanivenhaus A (2006) Age predicts outcome of high-tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 14(2):149–152

    PubMed  Article  CAS  Google Scholar 

  21. Yasuda K, Majima T, Tsuchida T, Kaneda K (1992) A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res 282:186–195

    PubMed  Google Scholar 

  22. Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE (2005) High tibial osteotomy. Review. J Am Acad Orthop Surg 13(4):279–289

    PubMed  Google Scholar 

  23. Wright J, Heck D, Hawker G, Dittus R, Freund D, Joyce D, Paul J, Young W, Coyte P (1995) Rates of tibial osteotomies in Canada and the United States. Clin Orthop Relat Res 319:266–275

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Gstöttner Michaela.

Additional information

An erratum to this article can be found at

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Michaela, G., Florian, P., Michael, L. et al. Long-term outcome after high tibial osteotomy. Arch Orthop Trauma Surg 128, 111–115 (2008).

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI:


  • High tibial osteotomy
  • Survival
  • Long term