Acta Ortopédica Brasileira
versão On-line ISSN 1809-4406
AVAKIAN, Roger et al. High tibial osteotomy in patients with knee arthrosis. Acta ortop. bras. [online]. 2008, vol.16, n.3, pp. 152-156. ISSN 1809-4406. http://dx.doi.org/10.1590/S1413-78522008000300005.
PURPOSE: To assess medial gonarthrosis treatment with wedge-like side-closed tibial osteotomy combined with proximal tibial-fibular joint release. METHODS: we employed this technique combined with proximal tibial-fibular joint release in the treatment of medial gonarthrosis in 36 patients (41 knees), from January 1995 to April 2003, with mean age of 53.4 years, followed-up for 51.6 months (in average). RESULTS: In the assessment, we noticed that wedge-like side-closed tibial osteotomies allow for a satisfactory repair of the femorotibial deformity, with end femorotibial angle of about 7° valgus; the mechanical axis was dislocated from the medial region of the tibia (position: 1.2%) to knee center (position: 50.5%); the 9.8° tibial bent at preoperative lateral plane was fixed to 6.5° (mean); joint motion showed 2.3° loss at extension (mean). CONCLUSION: This technique allows for a satisfactory repair of femorotibial varus deformity, but is not free of complications (14.6%). The level of patient satisfaction (Lysholm) grew from 27.3 to 89. Thus it constitutes an essential part of the gonarthrosis treatment arsenal.
Palavras-chave : Osteotomy; Osteoarthritis; Tibia.