Clinical results of a valgus high tibial osteotomy for the treatment of osteoarthritis of the knee and the ipsilateral ankle

The treatment of patients with osteoarthritic knees accompanied by ipsilateral osteoarthritic ankles is not well documented. We here report both clinical results and radiographic evaluations of such patients treated using a high tibial osteotomy (HTO). HTO was performed on 16 knees of 10 patients (all women with a mean age; 68years; range 58 to 73years) who bad a varus deformity of both their legs as a result of medial compartmental osteoarthritis of their knees. The Hospital for Special Surgery's (HSS score) knee scoring system and the clinical rating system for the ankle-hindfoot by Kitaoka (AOFAS) were used to evaluate the patients clinically before and after HTO. Radiographic findings were measured using antero-posterior one-leg weight bearing radiographs of the whole lower extremity taken before surgery. The mean time of follow-up was 8years (range, 4-10years). The HSS score improved from 54 to 91 points after HTO and the mean ankle score improved significantly from 54 to 86 points. After HTO also, the alignment of the knees changed from 6 degrees varus to 12 degrees valgus. The decrease of the inclination angle of the tibial axis changed from 10 degrees laterally to -2 degrees medially and the talar tilt angle improved from 18 degrees to 6 degrees resulting in an improvement of the ankle congruity. HTO, which can correct the total alignment of the lower extremity, is thus recommended as one of more effective surgical procedures for patients with an ipsilateral osteoarthritis of the knee and ankle. (C) 2008 Elsevier B.V. All rights reserved.