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High tibial osteotomy combined with anterior displacement of the tibial tubercle for osteoarthritis of the knee

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Summary

Eighty-nine knees with medial tibiofemoral and patellofemoral osteoarthritis were treated by high tibial osteotomy between 1972 and 1978, and 71 were followed up for at least 5 years, the average being 6 years and 9 months. There was no significant loss of motion as recorded before and after operation. In most patients pain decreased or disappeared, and walking ability was regained. Evaluation using the Japanese rating system showed that there were Good and Fair results in 86% of the cases. The average tibio-femoral angle in the Good group was 169±5°. The angles in the Poor group varied over a wide range. There were serious complications such as nonunion, malunion and infection in a few cases. In Group 1 (30 knees) high tibial osteotomy alone was performed. In Group 2 (41 knees) there were associated osteoarthritic changes in the patellofemoral joint and a high tibial osteotomy was combined with anterior displacement of the tibial tubercle (ventralisation). In comparison, Group 2 had better results with regard to both clinical and radiological evaluation.

Résumé

Sur 89 genoux de gonarthrose traités par ostéotomie tibiale haute, de 1972 à 1978, 71 ont été suivis au moins 5 ans, en moyenne 6 ans et 9 mois. Les résultats ont été bons ou passables dans 86% des cas. Il n'y a pas eu de perte notable de la mobilité du genou par rapport à l'état pré-opératoire. Dans la plupart des cas la douleur a disparu ou diminué et les possibilités de marche ont été récupérées. Il n'y a eu qu'un petit nombre de complications, telles que pseudarthrose, cal vicieux ou infection. Les meilleurs résultats ont été obtenus quand l'angle fémoro-tibial post-opératoire était de 169° ±5, les plus mauvais avec une grande disparité de cet angle. Un premier groupe (30 genoux) a été traité par ostéotomie tibiale haute isolée. L'autre groupe (41 genoux), présentant une ostéoarthrite fémoro-patellaire importante, a été traité par ostéotomie tibiale haute, associée à une transposition vers l'avant de la tubérosité tibiale antérieure. Les résultats obtenus dans le second groupe ont été plus satisfaisants sur le plan clinique et radiologique.

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Authors and Affiliations

  1. School of Medicine, University of Hokkaido, Kita-15, Nishi-7, Kita-ku, 060, Sapporo, Japan

    T. Sasaki, T. Yagi, J. Monji, K. Yasuda & H. Tsuge

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  1. T. Sasaki
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  2. T. Yagi
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  3. J. Monji
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  4. K. Yasuda
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  5. H. Tsuge
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Additional information

Read at the 16th Congress of the Societe Internationale de Chirurgie Orthopedique et de Traumatologie, London, England, 5th October, 1984

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Sasaki, T., Yagi, T., Monji, J. et al. High tibial osteotomy combined with anterior displacement of the tibial tubercle for osteoarthritis of the knee. International Orthopaedics 10, 31–40 (1986). https://doi.org/10.1007/BF00266270

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