Abstract
Clinical results were investigated after high tibial osteotomy for medial compartmental osteoarthritis of the knees with flexion contracture (limitation of terminal extension) above 20° in 53 patients, 4 men (4 knees) and 49 women (57 knees) . Preoperative flexion contracture averaged 24° (range, 20° to 40°) . The average age of patients at surgery was 65 years (range, 45 to 83) and the average length of follow-up was 5.3 years (range, 0.5 to 15.8) .
Several kinds of additional surgical procedures were used alone or in combination to correct flexion contracture at the time of osteotomy. These techniques included subperiosteal elevation of pes anserinus in all 61 knees, resection of the f ibular head in 21 knees, and resection of the table-like osteophyte in front of the tibial spine in 15 knees. If flexion contracture remained after these procedures, an anteriorly-based wedge was added. In only two knees, posterior release of soft tissue was done at the removal of a blade plate after osteotomy.
Postoperative flexion contracture of the knees was corrected to an average 8° and only 7 knees had a flexion contracture above 20° at follow-up. The arc of motion was 100°±20° preoperatively and 103°±24° at follow-up. There was no significant difference between them. The femoro-tibial angle (standing) was 186.2°+5.8° preoperatively and 169.1°±7.9° at follow-up. Good postoperative limb alignment was obtained. The knee function score using the criteria for evaluation of osteoarthritis of the knee of the Japanese Orthopaedic Association was 56±10 points preoperatively and 77±14 points at follow-up.
Satisfactory results were obtained by high tibial osteotomy for osteoarthritis of the knee with severe flexion contracture.
