UPPER TIBIAL OSTEOTOMY FOR GONARTHROSIS W ITH VARUS DEFORMITY - A REPORT OF 193 CASES REVIEWED 6 TO 10 YEARS POSTOPERATIVELY

The autors have analyzed the results of 193 tibial osteotomies with va rus deviation reviewed after an average 8 year follow-up. There were 7 1 per cent of good results. 14 patients (7.2 per cent) were reoperated for unsuccessful osteotomy. The optimal postoperative tibio-femoral a xial alignment was obtained between 3-degrees and 5-degrees valgus. Th e analysis of the series illustrates clearly the criteria of good resu lts thus providing a guide to surgical indication. It is a question of the preoperative height of medial tibio-femoral space being higher or equal to 50 per cent of the normal, a constitutional tibial varus ove r 50, a preoperative mechanical axis of less or equal to a 100 varus, the absence of subluxation of the tibial eminences. Statistically the most important factor (p = 0.0004) was the height of the medial tibio- femoral space of which the decrease illustrates the stage of developme nt of A.0. Finally, in the case of arthritic genu varum, the painful p atello-femoral syndrome progresses favorably in the case of good surgi cal indication on the medial tibio-femoral compartment.