Tibial osteotomy in the treatment of varus osteoarthritic knee

Fifty-three patients treated between 1979 and 1986 with high tibial osteotomy for varus osteoarthritic knee are evaluated. The average follow-up was 6 years and 8 months (range 3-10 years). All of the osteotomies were stabilized using Weber's method. The purpose of the operation was to realign the mechanical axes with overcorrection of 3 degrees. Results were good in 71% of the patients, and 85% claimed to be satisfied with the operation. The preoperative varus, 9.5 degrees on average, was corrected to 2-degree valgus; the deformity was exactly corrected in 59% of the cases, undercorrected in 9%, and overcorrected in 32%. The corrections slowly deteriorated over time. The correlation between the results and the stage of the arthritis, the degree of deformity, and the alignment of the mechanical axes showed that the best results were obtained in monocompartmental lesions with a varus deformity of less than 10 degrees and in osteotomies resulting in an average postoperative mechanical axis of 184.5 degrees. Weber's method has undeniable advantages over other methods, such as stable internal fixation, rapid healing, early restoration of articular function and resumption of weight-bearing.