High tibial osteotomy combined with joint debridement: a long-term study of results

Combined high tibial osteotomy and joint debridement have been performed in the treatment of unicompartmental osteoarthritis of the knee. A specially designed angled compression plate was used for fixation after a wedge upper tibial resection, and this permitted early joint motion and eliminated cast immobilization. Knee stiffness was thereby prevented. The adjunctive joint debridement enabled us to remove torn menisci, loose bodies and marginal osteophytes. Seventy-one patients were operated upon between 1966 and 1978. An average follow-up period of six years was recorded. Critical analysis of the results showed a satisfactory rate of 83%. This rate appeared to justify the rationale of the procedure, which is based on a belief that intra-articular pathology is responsible for the symptoms and that the deformity is secondary. Comparison with results of tibial osteotomy alone are favorable. The durability of results compares well with that of joint replacement.