Proximal tibial osteotomy in the treatment of osteoarthritis of the knee.

A long-term follow-up study is presented of 162 patients who were treated for knee arthrosis with proximal tibial osteotomy, 10 of whom had undergone a bilateral operation. The average follow-up time was 8 years. Pre-operatively, varus deformity was found in the knees of 117 patients; 45 of them had valgus knees. In 142 knees curved osteotomy was performed and wedge osteotomy in 30. At follow-up, 33% of the patients were found to have no pain. Significant long-term improvement was achieved, as registered at the time of follow-up, in 80% of the patients, whereas in 11% pain remained unchanged. Better results were recorded in women than in men (P less than 0.01). In the present study, slightly better results were obtained statistically using curved osteotomy (P less than 0.05). Postoperative plaster sleeve immobilisation for approximately 6 weeks (10 weeks at the most) gave the best results. Internal fixation seemed unnecessary.