Tibial osteotomy in medial gonarthrosis. The importance of over-correction of varus deformity.

In a prospective series of 52 knees selected for high tibial osteotomy because of early medial arthrosis, special care was taken to obtain a final over-correction in valgus. The operative procedure and the pre- and post-operative radiographic examinations were standardized and the follow up was 1-3 years. 49 of the 52 knees had obtained a normal or over-corrected mechanical axis. 45 of these had improved painfree walking distance, and 31 were painfree. In 45 knees the arthrotic condition had not progressed, and in 5 of these there were signs of cartilage restitution. It is concluded that precise correction of medial gonarthrosis can be achieved, and this provides a rational basis for definitive treatment of early stages of this condition: for the majority an endoprosthesis operation should not be needed in the future.