Debeyre's unicondylar osteotomy. Results in the treatment of lax arthritic genu valgum
Hernigou, P.; Goutallier, D.
Revue du Rhumatisme et des Maladies Osteo-Articulaires 55(8): 569-575
1988
ISSN/ISBN: 0035-2659 PMID: 3175515 Document Number: 310448
64 unicondylar varus osteotomies carried out on lax knees with advanced degenerative arthritis were reviewed with a mean follow-up of 9 years (5 to 18 years). 9 knees had to be reoperated early (during the 1st and 2nd post-operative year) because of complications occurring when this type of osteotomy was first performed. Among the 55 others, 44 knees are still markedly improved by the osteotomy: the knees are painless or almost painless, and restoration of the tension of the lateral ligaments at the time of osteotomy makes the laxity disappear quite lastingly. Modification of the articular relationships in the lateral femoro-tibial compartment reduces the sub-luxation and, post-operatively a lateral femoro-tibial interspace, which has not deteriorated in time, reappear. Femoro-tibial degenerations occurred after the 5th year and are related in 7 cases to a degeneration of the lateral femoro-tibial compartment and in 4 cases to a degeneration of the medial femoro-tibial compartment. In these 11 knees, the functional discomfort caused by the degeneration imposed, in the current follow-up, a re-operation for 5 of them (2 valgus tibial osteotomies in 2 medial femoro-tibial degenerations and 3 total knee prostheses in lateral femoro-tibial degenerations. Persistence of a valgus exceeding 4 degrees results in recurrence of the deformity; a definite hyper-correction resulted only exceptionally (2 cases) in a degeneration of the medial femoro-tibial compartment. Thus, unicondylar osteotomy seems able to improve lateral knee arthritis at an already quite advanced stage; but it requires a precise technique in order to avoid the early failures observed at the beginning of our experiment.