Varus inclination of the distal femur and high tibial osteotomy
Journal of Bone and Joint Surgery
W e have analysed retrospectively the relationship between the axial parameters of alignment of the lower limb and the recurrence of varus deformity after high tibial osteotomy. We studied 29 patients (37 knees) with a mean age at surgery of 66 years. The mean follow-up was for 7.4 years (5 to 10.5). Recurrence of varus deformity was defined as an increase in the femorotibial angle of 3° or more, compared with that obtained six months after the operation. There were four patients (four knees)
... ents (four knees) with recurrence of varus deformity. They had a greater varus inclination of the distal femur than those without varus recurrence. An association between varus inclination of the distal femur and horizontal obliquity of the joint surface was observed. Excessive obliquity prevents the shift of weight-bearing to the lateral compartment, and may cause a recurrence of varus deformity after high tibial osteotomy. J Bone Joint Surg [Br] 2002;84-B:223-6. High tibial osteotomy has long been used as surgical treatment for medial osteoarthritis of the knee. The importance of accurate realignment of the femorotibial axis has been recognised 1-16 and that a slight overcorrection gives 23. Jackson JP, Waugh W. Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg [Br] 1961;43-B:746-51. 24. Cooke TDV, Pichora D, Siu D, Scudamore RA, Bryant JT. Surgical implications of varus deformity of the knee with obliquity of the joint surfaces. J Bone Joint Surg [Br] 1989;71-B:560-5. 25. Terauchi M, Shirakura K, Katayama Y, Higuchi H, Takagishi K. The influence of osteoporosis on varus osteoarthritis of the knee. J Bone Joint Surg [Br] 1998;80-B:432-6. 26. Yoshioka Y, Siu D, Cooke TDV. The anatomy and functional axes of the femur. J Bone Joint Surg [Am] 1987;69-A:873-80.