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ANTEROMEDIAL OPENING WEDGE HTO FOR THE PCL DEFICIENT VARUS KNEE: A PROSPECTIVE FIVE YEAR FOLLOW UP



Abstract

Treatment of the young patient with medial compartment arthritis and a PCL deficient knee is a complex problem. This study evaluates the efficacy of the anteromedial opening wedge osteotomy for PCL deficient knees with medial compartment degenerative changes.

Eighteen patients have undergone an anteromedial opening wedge high tibial osteotomy for the PCL deficient varus knee. Patients were evaluated prospectively pre-operatively and at one and five years post surgery by visual analogue pain scores and patellofemoral pain scores, subjective IKDC, WOMAC and SF-36. Radiographic evaluation to determine correction in the coronal plane and the degree of slope increase was performed at one-year post surgery.

All patients reported and improvement in PCL instability. There was a significant improvement in visual analogue pain and patellofemoral pain sc ores, subjective IKDC, WOMAC and SF-36 and overall knee function at one and five years. Patients with less severe arthritis at the time of surgery performed better at five years.

This technique shows encouraging midterm results for a complex problem.

Better results are obtained with less significant arthritis at the time of surgery

Correspondence should be addressed to Associate Professor N. Susan Stott, Orthopaedic Department, Starship Children’s Hospital, Private Bag 92024, Auckland, New Zealand.