[Upper tibial osteotomy for gonarthrosis in genu varum. Apropos of a series of 193 cases reviewed 6 to 10 years later]

Abstract

The authors have analyzed the results of 193 tibial osteotomies with varus deviation reviewed after an average 8 year follow-up. There were 71 per cent of good results. 14 patients (7.2 per cent) were reoperated for unsuccessful osteotomy. The optimal postoperative tibio-femoral axial alignment was obtained between 3 degrees and 5 degrees valgus. The analysis of the series illustrates clearly the criteria of good results thus providing a guide to surgical indication. It is a question of the preoperative height of medial tibio-femoral space being higher or equal to 50 per cent of the normal, a constitutional tibial varus over 5 degrees, a preoperative mechanical axis of less or equal to a 10 degrees varus, the absence of subluxation of the tibial eminences. Statistically the most important factor (p = 0.0004) was the height of the medial tibio-femoral space of which the decrease illustrates the stage of development of A.O. Finally, in the case of arthritic genu varum, the painful patello-femoral syndrome progresses favorably in the case of good surgical indication on the medial tibio-femoral compartment.