体重指数对胫骨高位截骨手术临床疗效的影响

胫骨高位截骨手术是临床治疗膝关节骨性关节炎并膝内翻较常使用的、有效的治疗方法。有学者报导患者体重超标可以影响该手术的临床疗效[1]。本研究通过根据体重指数(BMI)分组:BMI≤24组与BMI>24组,共110例(136膝)膝关节骨性关节炎并膝内翻行胫骨高位截骨手术的疗效对照研究,探讨体重指数对该手术疗效的影响。1临床资料1.1一般资料将1999年5月～2003年3月住院行胫骨高位截骨手术治疗膝关节骨性关节炎并膝内翻的110例(136膝)纳入本研究。其中男29例,女81例,年龄43～65岁,平均54.5岁,膝痛病史1～12年,平均5.2年。术前有痛性跛行并存症状主…     

胫骨高位截骨合并骨膜移植治疗膝关节骨性关节炎

膝关节骨性关节炎十分常见，治疗较为困难。为了提高膝关节骨性关节炎的治疗效果，于１９８８年７月～１９９２年１０月，采用胫骨高位外翻截骨植骨矫正膝关节骨性关节炎膝内翻畸形的同时，用自体骨膜移植治疗髌骨软骨软化症。手术治疗３２例（５１个膝）。经平均５．１年随访，优良率为９０．２％，明显优于各式单纯胫骨高位截骨术。认为，该手术是治疗膝关节骨性关节炎膝内翻畸形伴髌骨软骨软化症的有效方法之一     

关节镜清理结合胫骨高位截骨治疗膝内翻骨关节炎

目的探讨膝内翻骨关节炎的诊治措施。方法19例（20膝）膝内翻骨关节炎患者采用关节镜清理，同时进行胫骨高位截骨术。先行关节镜清理术，同时探查关节内情况，确保外侧间室关节软骨无明显退变，然后行胫骨高位截骨术，术后行康复锻炼。结果本组随访时间16～52个月，平均34个月。全部病例均在术后6～10周获得骨性愈合，术后股胫角171°～175°，平均172．5°。Lyshoml-Ⅱ膝关节评分评定：术前19个膝评分40～56分，平均52分，术后评分82～98分，平均95分。结论关节镜清理术可以改善关节内紊乱，胫骨高位截骨术可以矫正异常的负重力线，二者结合用治疗膝内翻骨关节炎疗效肯定，较单一胫骨高位截骨术具有明显优势。     

胫骨高位截骨治疗膝关节骨关节炎并膝内翻

目的探讨胫骨高位截骨Giebel钢板内固定治疗膝关节骨关节炎并膝内翻的临床效果。方法从2008年8月至2012年2月,我科实施胫骨高位截骨Giebel钢板内固定手术治疗膝关节骨关节炎并膝内翻患者38例47膝。所有患者均以内侧间室疼痛为主。其中男13例15膝,女25例32膝;年龄36~58岁,平均48.5岁;应用HSS膝关节评分系统进行分析。结果 38例均获随访,随访18~24个月,平均20.2个月。术后未出现伤口感染、钢板螺钉断裂、膝内翻复发、骨不愈合等并发症。截骨处在术后12~14周均达到骨性愈合,疼痛症状均明显缓解或消失,摄片检查力线维持在术后水平。膝胫骨角术前平均为（102.1±4.3）°,术后平均为（91.5±4.1）°,所得资料采用配对t检验进行统计学分析,P〈0.01,具有明显的统计学差异。采用HSS膝关节评分标准进行疗效评价,优24膝,良16膝,中5膝,差2膝,优良率85.1%。结论胫骨高位截骨Giebel钢板内固定术式简单,组织创伤小,手术时间短,并发症少,患者下床活动早,功能恢复快,效果满意,是一种治疗膝内翻并膝关节骨性关节炎的良好方法。     

GIEBEL系统在胫骨高位截骨术中的应用

[目的]探讨GIEBEL内固定系统固定的胫骨高位截骨术治疗膝内翻畸形的效果。[方法]对19例31膝,平均53.5岁的膝内翻患者进行评价。术前内翻畸形平均12.29°;膝关节症状以内侧间室疼痛为主。不伴有其他关节间室病变。对患膝进行精确的胫骨高位截骨术后应用GIEBEL系统内固定截骨端。手术前后拍摄双下肢负重位全长X线片,测量内翻角、机械轴线和解剖轴线。记录内外侧关节间隙距离的差值以及关节活动度。同时进行Lysholm评分。术后对患者进行主观满意度调查。[结果]对19例患者平均随访22个月。术后1例腓总神经一过性麻痹,2例切口脂肪液化延迟愈合。截骨处至术后12~16周均骨性愈合。测量矫正角度平均12.32°。3例患者残留膝前疼痛和关节绞锁症状。在随访期间膝内外侧间隙无明显退变加重。手术效果优良率为89.5%。84.2%患者对手术效果表示满意。除膝关节活动度外,Lysholm评分、内外关节间隙差以及内翻角度在手术前后差异均有统计学显著性差异。[结论]GIEBEL系统可有效地固定胫骨高位截骨术截骨端,对轻中度膝关节内翻畸形患者固定强度大,骨愈合率高。     

胫骨高位双平面截骨术治疗膝内侧间室骨关节炎

目的探讨胫骨高位双平面截骨术治疗膝内侧间室骨关节炎的近期疗效。方法采用胫骨高位双平面截骨术治疗37例膝内侧间室骨关节炎患者。测量手术前后膝关节站立负重位X线片胫股解剖角、髋—膝—踝角,记录手术前后膝关节损伤和骨关节炎KOOS评分、KSS评分和疼痛VAS评分。结果患者均顺利完成手术。术后未出现感染、骨筋膜室综合征、腓总神经损伤、下肢深静脉血栓等并发症,截骨处愈合良好,患者膝内翻畸形情况均得到矫正。37例均获得随访,时间6~30(18.6±7.0)个月。胫股解剖角、髋—膝—踝角、KOOS评分、KSS评分、VAS评分术后3个月较术前明显改善,差异均有统计学意义(P<0.001)。结论胫骨高位双平面截骨术治疗膝内侧间室骨关节炎能够纠正下肢异常力线,缓解或者消除膝关节疼痛症状,短期疗效满意。     

胫骨高位截骨改良Giebel刃形钢板内固定治疗伴膝内翻的膝骨性关节炎

目的：观察胫骨高位截骨改良Giebel刃形钢板内固定治疗伴膝内翻畸形的膝骨性关节炎的临床疗效。方法：7例10个伴膝内翻畸形的膝骨性关节炎患者行胫骨高位截骨改良Giebel刃形钢板内固定术，术后观察x线及临床症状的变化。结果：所有病例均获得随访，随访时间8～24个月，平均16个月，截骨部位临床愈合时间为8～12周，平均10周，无1例不愈合，术后X线片示膝关节内侧间隙明显增宽，膝关节内翻畸形基本纠正，优良率为90％。结论：胫骨高位截骨改良Giebel刃形钢板内固定具有手术创伤小，固定牢固，早期功能锻炼，术后恢复快等优点。是治疗伴膝内翻畸形的膝骨性关节炎较年轻患者的一种首选方法。     

胫骨高位截骨术治疗膝关节骨性关节炎

自１９９０年５月－１９９５年１２月，应用膝关节外固定加压融合器行高位径骨截骨术治疗伴有膝内翻畸形的骨性关节炎１０例１０膝，并随访６个月－５年半，平均３年９个月。术后结果，股胫角由术前平均１８４．７°矫正到平均１７０．３°。评分由术前平均４７分，增加到平均８５分。手术采用胫骨楔形截骨，双期氏针加压外固定。术中同时行胫骨远端前移１ｃｍ，以改善髌股关节的负重关系。     

胫骨高位截骨治疗膝骨性关节炎中长期疗效分析

目的 :分析胫骨高位截骨治疗膝骨性关节炎的中长期疗效。方法 :自2001年1月至2005年12月,采用胫骨高位截骨术治疗45例63膝关节内侧间室骨性关节炎患者,男10例(15膝),女35例(48膝);年龄45~64岁,平均(54.76±5.54)岁。术前常规行膝关节负重正侧位X线检查,准确测量股胫角大小,根据术前股胫角决定胫骨外侧截骨量,手术均在硬膜外麻醉下常规行胫骨高位截骨术,大部分行腓骨中段截骨,部分病例行上胫腓关节松解。术后第2天即行功能锻炼,2周开始无负重下床活动,术后8~10周开始负重。术后第2天、8~10周、半年、1年及以后每年1次拍片复查,对全部病例术前、术后3~5年、术后10~14年采用视觉模拟评分(VAS)、美国特种外科医院膝关节评分(HSS)和美国膝关节协会评分(KSS)评价膝关节疼痛、畸形、功能和运动范围。结果 :43例(61膝)进行了10年及以上的随访,全部患者手术切口Ⅰ期愈合,术后8~10周截骨处均达骨性愈合。术后10~14年HSS评分平均76.24±5.27,优27膝,良25膝,可7膝,差2膝。术前与术后3~5年、术前与术后10~14年VAS、HSS、KSS比较有差异,术后3~5年与术后10~14年各项评分无明显差异。结论:胫骨高位截骨治疗膝骨性关节炎(内侧间室关节炎)只要手术指征掌握适当,术后积极锻炼,其中长期疗效满意。     

胫骨高位截骨术治疗膝骨关节炎并膝内翻体会

目的探讨胫骨高位截骨术治疗膝关节骨关节炎并内翻畸形的疗效。方法 2007年8月至2010年8月采用胫骨高位截骨术对35例50膝的膝关节骨关节炎并膝内翻患者进行治疗。手术前后拍摄患侧下肢负重位全长X线片,测量内翻角、FTA角、内外侧关节间隙距离及关节活动度,同时对患者进行HSS评分对比。结果对34例患者平均随访23.7个月。术后X线片示膝关节内侧间隙明显增宽,膝关节内翻畸形基本纠正,膝关节疼痛症状明显缓解,优良率为91.2%。结论胫骨高位截骨术对膝关节骨关节炎并膝内翻畸形患者有明显的疗效,早、中期效果较好。 更多还原     

Limb alignment after open-wedge high tibial osteotomy and its effect on the clinical outcome

The purpose of this study was to evaluate the accuracy of alignment after open-wedge high tibial osteotomy and its effect on the clinical outcome. A prospective case series of 56 consecutive patients underwent open-wedge high tibial osteotomy fixed with a TomoFix plate fixator (Synthes, West Chester, Pennsylvania). The correction angle was radiologically determined preoperatively and at 6 months postoperatively. The patients were clinically and radiologically examined preoperatively and at 3, 6, and 36 months postoperatively. The mechanical axis of 50 knees was corrected from an average of 5.7° varus to 1.3° valgus. Forty-three patients had an acceptable correction with Mikulicz line crossing the tibial plateau between 50% to 70% of the tibial plateau width measured from the medial border. Undercorrection (<50%, group II) and over-correction (>70%, group III) were found in 4 and 3 patients, respectively. The mean Lysholm-Gillquist score at 36 months had improved in all groups, with a statistically lower value for group II. Open-wedge high tibial osteotomy results in significant improvement of symptoms and function in all patients in the short term, even with under- and overcorrection of the osteotomy. Undercorrection was associated with a significantly lower clinical outcome in comparison to the accurate correction and overcorrection. Ligamentous laxity or soft tissue slackness of the knee can influence the overall correction after high tibial osteotomy and must be considered in preoperative planning. Patients with a high body mass index had inferior clinical results after open-wedge high tibial osteotomy.     

关节镜联合胫骨高位截骨治疗伴膝内翻的中老年患者内侧半月板退变性损伤

目的探讨关节镜联合胫骨高位截骨治疗伴膝内翻的内侧半月板退变性损伤的早期疗效。 方法回顾性分析2014年1月至2015年1月,西南医科大学附属医院骨关节外科收治的伴膝内翻的内侧半月板退变性损伤患者26例,采取关节镜联合胫骨高位截骨的手术方式进行治疗。其中男性18例（18膝）,女性8例（8膝）：年龄43~58岁,平均（49±6）岁。所有患者均为内侧半月板退变性损伤且伴有膝内翻,均行内侧撑开胫骨高位截骨,关节镜下半月板部分切除术缓解疼痛。测量下肢机械轴通过胫骨平台的相对位置、股胫角、胫骨平台后倾角;末次随访时评估膝关节各间室骨关节炎进展情况,采用Lysholm评分、美国特种外科医院（HSS）评分和Tegner膝关节运动评分评价膝关节功能,采用视觉模拟疼痛评分（VAS）评价疗效。 结果本组26例患者均获随访,随访时间为1.0~2.8年,平均为（1.6±0.5）年。未发现感染、下肢深静脉血栓形成、骨不愈合或延迟愈合等并发症。下肢机械轴通过胫骨平台的相对位置由术前（21.2±3.8）%改善至（59.5±1.7）%,股胫角由术前的（172±4）°改善至（179±4）°,差异均有统计学意义（t=14.257,P<0.05;t=10.572,P<0.05）。术前胫骨平台后倾角为（7.5±2.2）°,术后为（7.9±1.9）°,差异无统计学意义（t=1.628,P>0.05）。末次随访时,患者Lysholm评分、HSS评分、Tegner评分、VAS评分均较术前明显改善,差异有统计学意义（t=7.684,P<0.05;t=16.521,P<0.05;t=6.284,P<0.05;t=12.359,P<0.05）。 结论关节镜联合胫骨高位截骨治疗伴膝内翻的内侧半月板退变性损伤,能够有效改善下肢力线和缓解关节疼痛,早期临床疗效满意。     

胫骨结节远端单平面截骨术对髌骨高度的影响

目的观察胫骨结节远端单平面截骨术对髌骨高度的影响。 方法选取2017年8月至2018年10月于北京中医药大学第三附属医院微创关节科行胫骨结节远端单平面截骨术患者68例;其中男13例,女55例,年龄(64±7)岁。纳入标准：髌骨位置无严重偏移且术后随访资料完整;排除标准：关节镜对髌股关节进行干预治疗;严重膝关节韧带损伤伴功能不全;严重其他骨病;既往膝关节手术史;随访术肢并发二次损伤。采用Caton-Deschamps指数(CDI)、股骨髌骨高度指数(FPHI)评估髌骨高度的变化,髌骨轴位45°X线片Kellgren-Lawrence(K-L)分级评估髌股关节退化程度;采用美国特种外科医院评分(HSS)评估膝关节功能。使用重复测量的方差分析与卡方检验进行统计学分析。 结果68例患者均获得随访,随访时间(17±5)个月。CDI由术前的(0.94 ±0.14)改善为术后1周、术后12月时(0.91±0.21)、(0.89±0.17)(F＝0.451,P>0.05);FPHI由术前的(1.51±0.22)改善为术后1周、术后12月的(1.52±0.17)、(1.52±0.21)(F＝0.782,P>0.05);髌股关节K-L分级术前、术后1周及术后12月时无显著变化(χ² ＝0.479,P＝0.628)。HSS评分由术前(52±16)改善为术后3、12个月的(69±11)、(83±7),差异有统计学意义(F＝282.638,P<0.001)。 结论胫骨结节远端单平面截骨术对髌骨高度无明显影响,髌股关节未见显著退化。     

内侧撑开和外侧闭合胫骨高位截骨术治疗膝内翻骨关节炎

目的 比较两种胫骨高位截骨术的手术方法和临床结果.方法 膝内翻骨关节炎患者68例,其中37例采用外侧闭合胫骨高位截骨术(closed wedge high tibial osteotomy,CWO),31例采用内侧撑开胫骨高位截骨术(open wedge high tibial osteotomy,OWO).术后摄X线片测量胫骨平台后倾角、髌骨高度、胫骨股骨角、内侧胫股关节间隙宽度,并行HSS和Lysholm功能评分.结果 患者均随访24个月以上.术前、术后两组HSS和Lysholm评分差异均无统计学意义.(1)CWO组术前胫骨平台后倾角8.57°±1.63°、术后5.03°±1.24°,OWO组术前8.71°±1.66°、术后10.10°±1.30°,差异均有统计学意义.(2)CWO组术前Insall-Salvati指数0.880±0.053、术后0.820±0.049,差异有统计学意义;OWO组术前0.892±0.043、术后0.897±0.042,差异无统计学意义.CWO组术前Blackburne-Peel指数0.804±0.040、术后0.801±0.339,差异无统计学意义;OWO组术前0.815±0.039、术后0.766±0.037,差异有统计学意义.(3)术后CWO组外翻8.06°±2.75°,OWO组外翻8.65°±1.46°.结论 膝内翻骨关节炎的内侧撑开和外侧闭合胫骨高位截骨术有相似的手术效果,内侧撑开截骨术截骨角度更加准确.外侧闭合胫骨高位截骨术后可出现胫骨后倾减小和髌韧带短缩,内侧撑开截骨术后易出现胫骨后倾增加和髌骨至关节线距离减小.     

Knee scores change with length of follow-up after total knee arthroplasty

Patients undergoing primary total knee arthroplasty (TKA) between 1989 and 1994 were evaluated preoperatively and postoperatively with the Knee Society scoring system at 3 time intervals: 1 to 2 years, 3 to 6 years, and more than 7 years. Knee prosthesis and functional scores improved statistically after TKA. At last follow-up evaluation, a statistically significant decline was found in functional knee scores that was related to an increase in numbers of patients in category C. Progression of arthritis at other sites, especially lumbar spine and hips, and cardiopulmonary problems were the most common cause of limited functional capacity. Women were found to have lower preoperative and postoperative functional scores. Patient weight, body mass index (BMI), and age at surgery showed no correlation with postoperative functional scores. The inclusion of functional categories would appear to be warranted when reporting long-term results of TKA.     

Patterns and Predictors of Weight Change Before and After Total Hip Arthroplasty in Class 2 and 3 Obese Patients

BackgroundThis study aimed to better understand body mass index (BMI) change patterns and factors associated with BMI change before and after total hip arthroplasty (THA) in Class 2 and 3 obese patients, and assess if preoperative or postoperative BMI change affects postoperative clinical outcomes.MethodsWe retrospectively reviewed World Health Organization Class 2 and 3 obese patients (BMI > 35.0 at surgery) who underwent THA at a tertiary medical center from 2010 to 2020. BMI was recorded at 1 year preoperatively (mean 11.6 months), and at most recent postoperative visit (mean 29.0 months). Baseline demographics and postoperative clinical outcomes were recorded.ResultsWe reviewed 436 THAs with a mean age of 59.9 (11.5) years. Leading up to surgery 55.5% had unchanged BMI, and postoperatively 48.2% had unchanged BMI. Multivariate logistic regression revealed that those who lost BMI preoperatively were more likely to gain BMI postoperatively (odds ratio [OR] 3.28, confidence interval [CI] 1.83-5.97, P = .005), but those who gained >5% BMI preoperatively had no association with BMI change postoperatively. Those in a higher BMI class preoperatively were less likely to gain BMI preoperatively (Class 3 obese patients: OR 0.001, CI 0.0002-0.004, P < .001). African American patients were more likely to gain BMI preoperatively (OR 2.32, CI 1.16-4.66, P = .017). We did not detect an association between BMI change and postoperative clinical outcomes.ConclusionIn World Health Organization Class 2 or 3 obese patients, most maintained BMI between their first preoperative and final postoperative visit. Preoperatively, Class 3 obese patients were less likely to gain weight than Class 2 obese patients. The primary predictor of postoperative weight gain was preoperative weight loss. Weight change preoperatively and postoperatively were not associated with worse clinical outcomes.     

Impact of Tibial Tubercle Osteotomy on Final Outcome in Revision Total Knee Arthroplasty: Our Experience and Technique in Pakistan

BackgroudDue to extensive fibrosis during revision surgery, adequate exposure is essential and it can be achieved with several extensile approach options, such as tibial tubercle osteotomy. Information regarding surgical exposure during revision arthroplasty is limited in developing countries, such as Pakistan, due to the lack of adequate data collection and follow-up. Therefore, the purpose of this study was to evaluate the impact of tibial tubercle osteotomy on final outcome of revision total knee arthroplasty (TKA).MethodsA total of 231 revision TKAs were performed between January 2008 and December 2017. Twenty-nine patients underwent tibial tubercle osteotomy for adequate exposure during revision surgery. Of these, 27 patients with complete follow-up were included in our study. Factors examined include age at the time of revision surgery, gender, comorbidities, arthroplasty site (right or left), body mass index (BMI), and primary indications for the tibial tubercle osteotomy during revision TKA. Functional outcome was measured by using Knee Society score (KSS) at 3 months and the final follow-up. All statistical analysis was done using SPSS version 20.0 with a p-value < 0.05 considered significant.ResultsOut of 27 patients, 6 patients (22.2%) were men and 21 patients (77.7%) were women. Right knee revision arthroplasty was performed in 15 patients (55.5%), left knee revision arthroplasty was performed in 12 patients (44.4%), and bilateral revision surgery was performed in only 1 patient (3.7%). The mean BMI was 29.2 kg/m². We used a constrained condylar knee in 20 patients (74%), a rotating hinge knee in 5 patients (18.5%), and mobile bearing tray plus metaphyseal sleeves in 2 patients (7.4%). The KSS was 52.21 ± 4.05 preoperatively, and 79.42 ± 2.2 and 80.12 ± 1.33 at 3 months and 12 months, respectively. Radiological union was achieved in all patients at 3 months. Of 27 patients, only 1 patient (3.7%) had proximal migration of the osteotomy site at 6 months: the patient was asymptomatic and union was also achieved and, therefore, no surgical intervention was performed.ConclusionsTibial tubercle osteotomy during revision TKA can be a safe and reliable technique with superior outcomes and minimal complication rates.     

L’altezza della rotula dopo osteotomia tibiale prossimale: confronto fra tecnica di addizione mediale e sottrazione laterale

The clinical and radiographic results of patients with unicompartmental osteoarthritis or axial malalignment of the knee surgically treated with two different techniques of osteotomy of the proximal tibia were analysed. The patients, matched for age, sex and deformities, were divided into two groups: 47 cases treated with closed-wedge high tibial osteotomy and 40 cases with open-wedge high tibial osteotomy. For each case the height of the patella was measured by the Caton Method before surgery and at the last follow-up (at least 1 year after surgery). The purpose of this study was to analyse and search for any possible correlation between the variation of the patella and the degree of correction of the mechanical axis. It was concluded that patellar height after final osteotomy of the proximal tibia is modified and depends on the surgical technique used. Our study has shown a more frequent loss of patellar height with open-wedge high tibial osteotomy rather than closed-wedge high tibial osteotomy, the latter followed by a rather high rate of patellar elevation.     

Observations on patellar height following opening wedge proximal tibial osteotomy

Patellar height and patellar ligament length were assessed pre- and postoperatively in 28 patients who underwent a medial opening wedge proximal tibial osteotomy for varus gonarthrosis. This procedure produced no significant change in patellar ligament length. Pre- and postoperative Insall-Salvati ratios were 0.96+/-0.12 and 0.97+/-0.15, respectively (P=.30). The Insall-Salvati ratio decreased in 29% of patients, and no patient experienced a decline >0.07. The distance between the patella and tibiofemoral joint line ("patellar height") decreased in 100% of patients. The mean Blackburne-Peel ratio declined from 0.75+/-0.13 to 0.53+/-0.15 (P<.001). Sixty-four percent of the postoperative Blackburne-Peel values satisfied the radiographic criterion for patella infera (Blackburne-Peel ratio <0.54). Whereas the loss of patellar height, historically associated with lateral closing wedge proximal tibial osteotomy, is a function of patellar ligament contracture, the decreased distance between the patella and the tibiofemoral joint line following medial opening wedge proximal tibial osteotomy is a function of joint line elevation. The high incidence of patella infera following medial opening wedge proximal tibial osteotomy may have deleterious effects on patellofemoral biomechanics or may complicate subsequent total knee arthroplasty.     

The new “dual osteotomy”: combined open wedge and tibial tuberosity anteriorisation osteotomies

The high frequency with which medial compartment osteoarthritis is associated with patellofemoral osteoarthritis makes the addition of tibial tuberosity anteriorisation to high tibial osteotomy an appealing solution, despite the discouraging previously reported long-term results when tubercle anteriorisation was combined with a Coventry closed wedge technique. We conducted a prospective study of a new osteotomy combination: “the dual osteotomy”. An open wedge high tibial osteotomy was combined with 1- to 1.5-cm Maquet-like tibial tuberosity anteriorisation. Thirty-four knees in 30 patients underwent surgery, including ten knees in nine male patients and 24 knees in 21 female patients with a mean age of 45 years (age range 34−58 years). All patients had varus medial compartment osteoarthritis and patellofemoral osteoarthritis with preoperative anatomical tibiofemoral angle exceeding 5°. Twenty-four months after surgery, final evaluation detected improvement in the Knee Society clinical rating system function score from a mean of 61.3 (range 30−80) preoperatively to a mean of 87.3 (range 50−100) postoperatively and in the knee pain score from 27.3 (range 10−30) to 47 (range 30−50) postoperatively. Based on the rating system, at final follow-up, 70% of patients experienced no pain, 13% had mild or occasional pain, 10% had pain on stairs only, and 7% had pain during walking and on stairs. Anatomical tibiofemoral angles from 0 to 10° valgus were achieved in 91% of operated knees, and union was achieved in all cases within six to twelve weeks after surgery. The dual osteotomy was effective in the short term in cases of medial compartment osteoarthritis associated with patellofemoral osteoarthritis.