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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 5,
592-596.
doi: 10.1302/0301-620X.90B5.20386 Copyright © 2008 by British Editorial Society of Bone and Joint Surgery The long-term outcome of high tibial osteotomyA TEN- TO 20-YEAR FOLLOW-UPS. Akizuki, MD, PhD, Director, Chief Surgeon, Clinical Professor1; A. Shibakawa, MD, PhD, Attending Surgeon1; T. Takizawa, MD, PhD, Chief Surgeon1; I. Yamazaki, MD, Chief Surgeon1; and H. Horiuchi, MD, PhD, Chief Surgeon11 Department of Orthopaedic Surgery, Nagano Matsushiro General Hospital, 183 Matsushiro, Nagano City, 381-1231, Japan. Correspondence should be sent to Dr S. Akizuki; e-mail: sakizuki{at}hosp.nagano-matsushiro.or.jp
We carried out a prospective study of 132 patients (159 knees) who underwent closed-wedge high tibial osteotomy for severe medial compartment osteoarthritis between 1988 and 1997. A total of 94 patients (118 knees) was available for review at a mean of 16.4 years (16 to 20). Seven patients (7.4%) (11 knees) required conversion to total knee replacement. Kaplan-Meier survival was 97.6% (95% confidence interval 95.0 to 100) at ten years and 90.4% (95% confidence interval 84.1 to 96.7) at 15 years. Excellent and good results as assessed by the Hospital for Special Surgery knee score were achieved in 87 knees (73.7%). A pre-operative body mass index > 27.5 kg/m2 and range of movement < 100° were risk factors predicting early failure. Although our long-term results were satisfactory, strict indications for osteotomy are required if long-term survival is required.
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