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Closing wedge varus tibial osteotomies: Surgical technique and long term results
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assessment at a mean 10.4 years follow-up
(range: 3.1 years – 16.5 years).
The mean Knee Society objective scores
improved from 53.4 (range, 14-80) to 72.1
(range, 43-95) (p=0.001). The mean Knee
Society function score improved from 78.8
(range, 30-100) to 91.7 (range, 70-100)
(p=0.02). The mean pain score (0-50 points)
improved from 12.2 (range, 0-30) to 32.8
(range 10-45) (p < 0.001).
At the same point, the mean KOOS was 57
(range 20-76), pain: 66 (range 25-94), symptom:
57(range 18 – 82), ADL: 74 (32-96), Sport/rec:
30 (0-65), QOL: 57 (19-94).
Patients’ activity levels outcomes are recorded
table 1. A significant difference was found
between pre and postoperative values.
Radiographic outcomes
A significant difference was found between the
mean preoperative and postoperative values of
mechanical tibiofemoral angle (HKA), MPTA,
and tibial slope (Table 2). No significant
difference was found between the preoperative
Ahlbäck or Iwano grade and the radiographic
assessment of osteoarthritis at the final follow-
up (Table 3). Preoperatively, all patients but 3
had a normal mechanical axis or a valgus
deformity. At final follow-up, all the patients
but one had a varus deformity or normal
mechanical axis. Postoperative varus deformity
of more than 5° was recorded only in 3 patients.
All the patients but two had a postoperative
joint line obliquity under 10°.
Complications and subsequent
procedure
Hardware removal was performed in 6 patients
at a mean 1.7 years follow-up. At the same
time, two patients underwent arthroscopies for
persistent painful swelling. Partial lateral and
medial meniscectomies were performed and
relieved the pain. No major complications such
as infection, thromboembolic events, intra-
articularfractures,neurovascularcomplications,
delayed or non-union were recorded in the
study.
Table 1 : Patients’ activity levels outcomes
Table 2 : Mechanical axes and index
UCLA
asymptomatic
Preoperative
final
Median
9
6
8
Range
4-10
4-9
4-9
N
27
26
18
P<0.001
P<0.001
P=0.001
Preoperative
Post operative
p
Mean
Range
Mean
Range
HKA
184
178-188
178
170-186
<0.001
mLDFA
86
83-89
86
81-89
0.131
MPTA
90
83-94
83
77-89
<0.001
Tibial slope
83
80-87
86
80-90
<0.001
Caton’s index
0.9
0.7-1.3
0.9
0.4-1.4
0.375