Value of closing-wedge high tibial osteotomy for treatment of medial gonarthrosis

In young and active patients, closing-wedge high tibial osteotomies are reliable procedures in the treatment of osteoarthritis of the medial compartment of the knee. This has been consistently shown throughout the last 2 decades. The present study analyzes the long-term results of 217 patients after an average of 9 years and compares them to the results in the literature. Besides correction of the alignment,other prognostic factors such as the patients' age, overweight,the preoperative degree of osteoarthritis, but also a newer prognostic factor described by the Lyon knee school have been evaluated. The authors found that the tibial bone varus angle might be helpful to differentiate between a bony deformity of the proximal tibia, amenable to correction by osteotomy, and a secondary bony erosion of the medial tibial plateau, with a worse prognosis.