Valgus High Tibial Osteotomy (H.T.O.) in a recent past has unfairly been compared to Total Knee Replacement (T.K.R.); H.T.O. was unduly discarded as n unreliable procedure due to its supposed high rate of failures and/or complication; the clinical material which led to these conclusions was, in fact, predominantly poorly done H.T.O.’s. If, however, Valgus H.T.O.
Is performed (and achieves union) with the same technical predictable accuracy as T.K.R. Is evaluated with comparable statistical methods as T.K.R. (on the basis of survivorship analysis of postoperative knee function). T.O. remains a very valuable procedure to treat knee osteoarthritis, especially in still very active patients.
Since 1989, 49 “A.C.C.W.I.F.” H.T.O. were performed and followed up for at least three years (Automatic Correction through Closing wedge Internal Fixation). Using full-length radiographs and pre-operative planning, the technical accuracy was assessed immediately after surgery, at the time of union and at the last follow-up. Negative marks were given either in case of inadequate correction (more than 3° degrees of error to the pre-op planning) or in case of complication. The knee function was rated according to the I.K.S. scoring system. Excellent results were observed in more than 90% of the operated knees, with very little deterioration of the results with time. Survivorship of knee function was assessed using revision by T.K.R>
or repeat H.T.O. as its end point.
