OBJECTIVETo compare the therapeutic effect of impacted high tibial osteotomy and conventional high tibial osteotomy for the treatment of flexional medial osteoarthritis of knee joint in aged patients.

METHODSFrom July 2003 to July 2006, 30 patients with flexional medial knee osteoarthritis were treated with impacted high tibial osteotomy or conventional high tibial osteotomy randomly. All patients,aged from 60 to 82 years,were suffered from 7 degrees to 19 degrees knee flexion deformities and 3 to 20 years medical histories. The bone healing periods, the recover of flexion and inversion deformities, and the recover of the knee joint function were observed postoperatively. The patients were followed up at 4, 6, 8, 9, 10, 12 and 16 weeks, and 5, 7, 9 and 12 months postoperatively. The bone healing periods and the recover of flexional and inversion deformities were evaluated and compared. Twelve months postoperatively,the knee joint function were assessed with the Lysholm scoring criteria, and the therapeutic effects were compared between the two groups.

RESULTSThere was a significant difference in the average bone healing period between the impacted high tibial osteotomy group (9.26 +/- 2.23) weeks and the conventional high tibial osteotomy group (11.53 +/- 3.15) weeks. The knee joint function were evaluated according to the Lysholm clinical rating scales. One year postoperatively,the average Lysholm score were (88.5 +/- 4.4) points in the impacted high tibial osteotomy group,and the results showed excellent in 14 cases, good in 1. The average Lysholm score were (78.1 +/- 5.7) points in the conventional high tibial osteotomy group. The results showed 8 cases excellent, 5 good, 2 fair, accordingly. Postoperatively, the flexion deformities of the knee in the impacted high tibial osteotomy group were -1.1 degrees to 0 degrees and was corrected averagely (130 +/- 3.30) after surgery, and that in conventional high tibial osteotomy group (140 +/- 3.30) (the same as preoperation). The average postoperative femorotibial angle (FTA) were 170.2 degrees (ranged from 169.1 degrees to 172.3 degrees) and was corrected 12.3 degrees to 12.5 degrees after surgery in both groups.

CONCLUSIONCompared with conventional high tibial osteotomy, impacted high tibial osteotomy can significantly shorten the bone healing period, improve the knee flexion, varus deformity, and the knee function.