THE ROLE OF REHABILITATION AFTER HIGH TIBIAL OSTEOTOMY IN PATIENTS WITH MEDIAL GONARTHROSIS

Forty osteoarthritic patients with symptomatic genu varum were treated with proximal valgus osteotomies of the tibia. Lateral closing wedge tibial osteotomies were carried out; associated fibular osteotomies we re not performed, but the proximal tibiofibular syndesmosis was excise d in all cases. All the osteotomies were fixed with staples. The purpo se of the operation was to realign the anatomical axis with an over-co rrection of 5-degrees. The patients were randomly placed into two grou ps to investigate the effects of immediate mobilization on rehabilitat ion after high tibial osteotomy. In group A, the knee was immobilized for 6 weeks, and weight-bearing was begun after 8 weeks. In group B, j oint motion was begun immediately, and weight-bearing was initiated af ter 4 weeks. The mean age of the patients was 62 years (range, 53-65) and the follow up period was 4.5 years on average (range, 3-6). The re sults were classified as good, fair, and poor according to Coventry's rating system. Functional results in group A were 14 good, four fair, and two poor. Group B showed the following functional results: 12 good , six fair, and two poor. All patients regained knee motion without co mplications, with no difference between the groups.