High Tibial Osteotomy for Rheumatoid Arthritis of the Knee: A One to Six Year Follow-Up Study

Although high tibial osteotomy for osteoarthrosis of the knee joint is well recognized, its place in the management of rheumatoid arthritis of the knee is much less well established. Thirty-six rheumatoid knees were reviewed 1 to 6 years following tibial osteotomy. The results were 42 per cent good, 19 per cent satisfactory and 39 per cent poor. No patient remained free of pain for more than 3 years, and recurrence of pain was not always associated with recurrence of deformity. Varus knees did considerably better than valgus knees despite some technical errors. Maintenance of a normal femoro-tibial angle range of 164° to 177° at follow-up was important but not as vital as in osteoarthrosis of the knee. The beneficial effect of tibial osteotomy in rheumatoid arthritis of the knee seldom lasted more than 3 years after which time an increasing number of bad results were seen. It was concluded that high tibial osteotomy was a satisfactory procedure for rheumatoid arthritis of the knee but its efficacy was not comparable to that seen in osteoarthrosis nor was its effect long-lasting.