A long-term follow-up study of high tibial osteotomy for medial compartment osteoarthrosis

Objective: To observe the long-term outcome of high tibial osteotomy (HTO) in treating medial compartment osteoarthrosis of knees. Methods: A retrospective study was carried out on 194 patients (215 knees) treated with HTO for medial compartment osteoarthritis at the Orthopaedic Hospital of Kiel University between 1985 and 1996. Results: One hundred and sixty-one knees (144 patients) were followed up for (1.5)-12 years with an average of (7.5) years and their data were reviewed. The proportion of excellent outcome were (97.3)%, (93.6)% and (78.2)% two, five and over five years after HTO, respectively. The revision rate of total knee arthroplasty (TKA) was (11.8)% (19 knees retreated with TKA for HTO failure). The survivorship analysis of the 19 knees retreated with TKA showed an expected survival rate of (98.7%), (95.0%) and (84.1)% 2, 5 and 10 years after HTO, respectively. There were (5.6)% complications (12 /161), including five superficial wound infections, one deep infection, five delayed bone healing, and one peroneal nerve palsy. Fifty patients (54 knees) missed follow-up, among them 10 patients (11 knees) died.Conclusions: HTO is an effective method in treating medial compartment osteoarthritis with a varus knee. Appropriate overcorrection of femorotibial alignment is the key for the success of the operation. But as the long-term effect is concerned, there is a trend of deterioration and some of the patients may have a second operation of revision with TKA.