Le osteotomie tibiali di addizione nelle gonartrosi e nelle deformità post-traumatiche in valgo: indicazioni, tecnica chirurgica, complicanze, risultati

Abstract

The effectiveness of tibial osteotomy for the treatment of varus gonarthrosis has been widely discussed in the literature, while works reporting its role in the correction of constitutional or acquired post-traumatic valgus deformities are less numerous, if not rare. We present the study of 16 patients with valgus knee treated by external opening wedge tibial varus osteotomy above the tibial tuberosity between 1998 and 2008. We analyzed the results with a median follow-up of 6 years (range 2–12 years): with the rating scale of Lysholm and Gillquist, the average value was 83 (range 61–93). Our indication for surgical intervention was addressed to subjects aged <60–62 years with unadvanced valgus gonarthrosis, <12°, with medial-lateral laxity, mostly occurring after lateral spontaneous or surgical meniscectomy, outcomes of tibial lateral plateau fracture or constitutional valgus deformities. Under such conditions, this procedure, that is performed in intraligamental area, can restore ligament tension and rebalance the knee, at the cost of an acceptable joint line’s obliquity.