[Corrective osteotomy of the head of the tibia in primary and secondary gonarthrosis--a para-articular operation]

The corrective osteotomy at the head of the tibia with degenerative or posttraumatic medial or lateral gonarthrosis and misalignment of the axis is until today a procedure to be recommended prior to a total or partial implantation of an endoprosthesis. The main advantage in comparison with a mono-condylar prosthesis is the removal of the causal damage of the misalignment. Old age and general relative risks are no contraindications to this procedure. The method used most in the operative technique is the correction of valgus deviation at the head of the tibia after osteotomy of the fibula with stabilization with a fixateur externe. On the whole, the risk of the operation is very low, the main complication is the lesion of the nervus peronaeus. With regard to the subjective result from the patients point of view the most important aspect is the relief or disappearance of pain, which is reached in comparison with a partial prosthesis of the knee joint with similar security. About two thirds of the patients are subjectively contempt with the results of the operation within a time of three to five years.