抄録
Objective and Methods: In order to detect the onset of osteoarthritis, super long-term follow-ups were performed on corrective osteotomies done since 1969 on young patients under 40 years of the age with bowlegs, knock knees and flexion rotational deformities around the knees. Among them 57 knees (29 left, 28 right) of 45 patients (19 male, 26 female) were followed-up for more than 10 years with an average of 18.8±5.8 years. The follow-up period ranged from 30 to 38 years in 7 patients with 7 knees, from 20 to 29 years in 9 patients with 11 knees and from 10 to 19 years in 29 patients with 39 knees. A supracondylar femoral osteotomy was performed on 12 knees of 11 patients, high tibial osteotomy above the tibial tuberosity on 10 knees of 8 patients and below the tuberosity on 49 knees of 38 patients.
Results and Conclusion: At the final follow-up the varus and valgus deformities were satisfactorily corrected in all cases to obtain straight limb alignment and correction of the rotational deformities. At the final follow-up the age of these patients ranged from 42 to 71 years and no osteoarthritis was noted except for 9 knees in which 7 knees had dull pain after strenuous sport with osteoarthritic abnormalities such as osteophytes and so on revealed by x-ray imaging. The remaining two knees, where the initial deformity was due in one case to pyogenic arthritis and in the other to Morquio syndrome, developed secondary painful osteoarthritis and total knee replacements were performed 27 years and 10 years, respectively, after the initial osteotomies. Two patients developed symptoms and radiographic osteoarthritic abnormalities in the knees contralateral to the initial osteotomy side at the final follow-up, at the age of 71 years, 35 years after the initial osteotomy in one and at 67 years of age, 33 years postoperatively in the other.
