Clinical effectiveness of high tibial osteotomy for osteoarthritis of the knee.

An audit of high tibial osteotomy was done for 96 knees in 81 patients who had pain due to medial compartment osteoarthritis (OA) of the knee. The mean follow-up was 4.5 years. A modified preoperative and postoperative knee score was used to assess the knee pain and function for each patient. The standard 5-year follow-up results for this procedure, as described in the literature, is 85%. Our results were 71% satisfactory and good. This was because a large proportion of the Salisbury population was involved in farming and they wanted to carry on strenuous activities. Therefore they were not suitable candidates for total knee replacement. Since then we have changed our practice and are restricting this procedure to people who are less than 65 years old and we perform a pre-osteotomy arthroscopy as a matter of routine. It has been 2 years now since we have changed our practice. We will have to wait for at least 3 more years to evaluate our 5-year results in order to close the audit loop.