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Prognostic factors in the outcome of supracondylar femoral osteotomy for lateral compartment osteoarthritis of the knee.
OBJECTIVE: To identify the demographic and operative factors that determine outcome in supracondylar femoral osteotomy for lateral compartment osteoarthritis of the knee.
DESIGN: Clinical and radiologic review of a nonrandomized, consecutive one-surgeon series.
SETTING: A university-affiliated, elective surgical referral centre.
PATIENTS: Forty-nine consecutive patients with unicompartmental osteoarthritis of the knee, involving the lateral compartment, and of sufficient severity that the alternative surgical procedure would be total knee replacement.
INTERVENTION: Supracondylar varus osteotomy stabilized with a blade plate.
MAIN OUTCOME MEASURES: Knee function measured by the Knee Society Score and time to conversion to total knee replacement.
RESULTS: A Knee Society Score greater than 80 was obtained in 81% of patients, but in the function portion of the measurement only 30% had a similar score. After discarding the patients who died, life-table analysis demonstrated the predicted survival before conversion to total knee replacement to be 87% at 7 years. There was no correlation with patient age or sex, femorotibial angulation, amount of correction or time after the intervention. Removal of the fixation device improved the clinical result.
CONCLUSION: The role of supracondylar femoral osteotomy remains poorly defined, but the procedure can delay total knee replacement for considerable time in appropriate patients.
DESIGN: Clinical and radiologic review of a nonrandomized, consecutive one-surgeon series.
SETTING: A university-affiliated, elective surgical referral centre.
PATIENTS: Forty-nine consecutive patients with unicompartmental osteoarthritis of the knee, involving the lateral compartment, and of sufficient severity that the alternative surgical procedure would be total knee replacement.
INTERVENTION: Supracondylar varus osteotomy stabilized with a blade plate.
MAIN OUTCOME MEASURES: Knee function measured by the Knee Society Score and time to conversion to total knee replacement.
RESULTS: A Knee Society Score greater than 80 was obtained in 81% of patients, but in the function portion of the measurement only 30% had a similar score. After discarding the patients who died, life-table analysis demonstrated the predicted survival before conversion to total knee replacement to be 87% at 7 years. There was no correlation with patient age or sex, femorotibial angulation, amount of correction or time after the intervention. Removal of the fixation device improved the clinical result.
CONCLUSION: The role of supracondylar femoral osteotomy remains poorly defined, but the procedure can delay total knee replacement for considerable time in appropriate patients.
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