Proximal tibial valgus osteotomy for hemophilic arthropathy of the knee

Between 1975 and 1985, 14 hemophilic patients with symptomatic genu varum were treated with proximal valgus osteotomies of the proximal tibia; lateral closing wedge tibial osteotomies were carried out; associated fibular osteotomies were not performed, but the proximal tibiofibular syndesmosis was excised in all cases. The mean age of the patients was 32 years, and the average length of follow-up was 6.5 years. Clinical evaluation was undertaken using a modification of the Hospital for Special Surgery Knee Rating Score. Eleven patients (78.5%) had improvements in their postoperative scores, and three patients (21.5%) deteriorated. Postoperative pain decreased in patients who had successful results with no evidence of deterioration over time. There was one case of superficial wound infection, which cleared after the administration of intravenous antibiotics. We conclude that our simplified technique for proximal tibial valgus osteotomy is an effective and reliable treatment method for painful genu varum of the hemophilic knee.