Long term results of high tibialosteotomies

Question: Long term outcome after high tibial osteotomies is essential too for the actual indication of these procedures. Complications and success rate were analysed in our patients in order to find out predictive determinants for the outcome. Method: 200 high tibial osteotomies were performed at the Orthopaedic clinic of Kiel University between 1974 and 1983. 148 knees (74%) could be reviewed with an average follow-up period of 10 years. 103 knees were personally examined, 45 cases were investigated by questionaire. Results: 74% were content with the result of the operation; Deterioration of complaints could be stopped in many cases, although the radiographic changes were not parallel to subjective relief of pain. The survival rate without implantation of knee prosthesis was 96% 12 years postoperatively. In 10 cases which had continuous complaints knee arthroplasties were performed one to two years after high tibial osteotomy. 6 knees required additional surgery because of loss of correction. Serious complications did not occur apart from one peroneal nerve palsy and two deep though completely healed infections. Conclusion: High tibial osteotomy in a modified procedure according to Coventry thus guaranties long term success with low risk of failure only.