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Deterioration of long-term results following high tibial osteotomy in patients under 60 years of age

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Abstract

We have investigated, in a prospective study, the outcome of a valgus osteotomy of the tibia in patients less than 60 years of age with arthrosis of the medial compartment and a varus angle of no more than 177.7°. Included in the study were 44 high tibial osteotomies (HTO) performed in 42 patients from 1981 until 1996. There were 35 females (2 bilateral) and 7 males, with an average age of 51 years (range: 30–60 years). Only patients in the first three grades, according to Ahlback’s classification, were included. During a mean follow-up period of 10 years (range: 5–17 years), all but 2 patients experienced pain relief. The average loss of postoperative correction at 10 years was 2.4°. The average postoperative Hospital for Special Surgery Knee Rating System score (HSSK) for patients with excellent or good results was 83.5 points. Survivorship analysis showed a success rate of 80% and 66% at 10 and 15 years respectively, and over 52.8% at 17 years of follow-up. HTO results in redistribution of the main stresses towards normal levels, although normal values are never attained. This is probably the reason why patients experienced good results only in the medium term.

Résumé

Nous avons réalisé une étude prospective sur le devenir des ostéotomies tibiales de valgisation chez les patients de moins de 60 ans, présentant une arthrose du compartiment médial du genou et un varus qui était toujours inférieur à 177,7°. Nous avons inclus dans cette étude 44 ostéotomies tibiales proximales, réalisées chez 42 patients de 1981 à 1996 (35 sujets féminins don’t 2 ostéotomies bilatérales et 7 sujets masculins). L’âge moyen était de 51 ans (entre 30 et 60). Seuls les patients présentant une lésion classée dans les trois premiers grades de la classification d’Ahlback ont été inclus. Après un suivi moyen de 10 ans (entre 5 et 17 ans), tous les patients ont été revus sauf deux. La perte de correction à 10 ans était de 2,4°. Le score HSSK était de 83,5 points (excellents et bons résultats), la courbe de survie a été de 80% à 10 ans et 66% à 15 ans, 52,8% à 17 ans. L’évolution de l’ostéotomie tibiale proximale montre qu’avec le temps se produit une récidive de la déformation ce qui explique de bons résultats uniquement à moyen terme.

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Authors and Affiliations

  1. 2nd University Department of Orthopaedics, National and Kapodistrian University, Constantopoulion Hospital, Athens, Greece

    G. Papachristou, S. Plessas, J. Sourlas, C. Levidiotis, E. Chronopoulos & C. Papachristou

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  1. G. Papachristou
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  2. S. Plessas
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  3. J. Sourlas
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  4. C. Levidiotis
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  5. E. Chronopoulos
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  6. C. Papachristou
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Correspondence to G. Papachristou.

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Papachristou, G., Plessas, S., Sourlas, J. et al. Deterioration of long-term results following high tibial osteotomy in patients under 60 years of age. International Orthopaedics (SICOT) 30, 403–408 (2006). https://doi.org/10.1007/s00264-006-0098-7

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  • DOI: https://doi.org/10.1007/s00264-006-0098-7

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