Evaluation of treatment of late-onset tibia vara using gradual angulation translation high tibial osteotomy

Late-onset tibia vara or Blount's disease is the most common cause of pathologic genu varum in children and adolescents. Treatment remains controversial. Many studies in the past have shown that an osteotomy with acute correction is the most appropriate treatment. More recently however, there has been a growing interest, especially in severe cases, in using gradual correction with the Ilizarov technique after a single high tibial osteotomy. A retrospective study in 20 children with late-onset tibia vara, who were treated by gradual angulation translation high tibial osteotomy using the Ilizarov technique, was performed. The mean follow-up period was 2.9 years (range: 2-4 years; SD 0.75). Recurrence of varus deformity to various degrees was noted in 10 of 22 cases (45.5%). Recurrence of deformity was found to be significantly related to both the degree of pre-operative deviation and the duration of follow-up. No statistically significant relationship was found between recurrence and the age of the patients at the time of the operation. Angulation translation high tibial osteotomy using the Ilizarov technique is a unique method for realignment of the mechanical axis in late onset tibia vara. It also allows for correction of associated deformities. The rate of recurrence of varus deformity is however relatively high.