Introduction and purpose: To assess the long-term results of Coventry-type tibial osteotomies performed in our center.

Materials and methods: This is a retrospective study. We carried out a review of 324 histories of Coventry-type osteotomies selected from a total of 76 with a mean follow-up of 12.9 years (minimum 5, maximum 25). We reviewed the patients’ preoperative assessment, postoperative assessment and last assessment or consultation before a total knee replacement. We also looked at the clinical evaluation of the patients’ pain, degree of arthritis on x-ray (Ahlbäck) and degree of postoperative correction obtained.

Results: 76 cases. Mean age 57.9 years (range: 35–72). Radiological degree of arthritis: 36.8% slight; 57.9% moderate; 5.2% severe. We found that patients with slight arthritis at the end of follow-up (mean 12.5 years) had 71% of satisfactory results. Satisfactory results were seen in 50% of patients with moderate arthritis (mean follow-up 16 years). With reference to the degree of correction, patients with mild over-correction had better results (8–12° valgus), followed by those normally corrected (0–8° valgus). A total of 30 patients (41%) required TKR at the end of their evolution (mean period of 13 years to TKR).

Conclusions: In spite of the advances of prosthetic surgery, the Coventry osteotomy continues to be appropriate in mild to moderate single-compartment arthritis. In the long term slight over- correction provides better outcomes.