Abstract
Aims
The purpose of our study was three fold; firstly to assess the survival of closing wedge high tibial osteotomies (CWHTO), secondly to assess any clinical factors or radiological alignment which may affect survival and thirdly to assess the change in tibial inclination and patella height.
Methods
Details of 51 patients undergoing CWHTO for varus gonarthrosis between 1999 and 2007 were assessed for age, BMI, gender, range of movement, meniscal integrity and grade of arthritis. Radiological evaluation included pre and post-operative femoro-tibial axis, tibial slope and patella height. Outcome was also evaluated by Oxford knee score and UCLA activity score. Failure was considered as conversion to arthroplasty.
Results
At 8 years Kaplan Meier analysis demonstrated 81%survival (95% CI 0.62 to 0.91) with arthroplasty as the endpoint. Cox proportional hazard ratios demonstrated no significant relationship to gender, pre-operative range of movement, meniscal integrity grade of osteoarthritis or post-operative leg alignment, but failure was more likely to occur in the older patient. Radiologically there was a statistically significant reduction in tibial slope but only a minimal change in patella height.
Conclusion
We believe CWHTO can have good medium term results for younger patients with osteoarthritis. Although we could not find any significant relationship to survival for leg alignment, it will reduce the tibial slope and minimally affect the patella height.
