Bilateral early knee osteoarthritis treated with unilateral proximal tibial osteotomy and contralateral non-surgical technique

Abstract

Some non-surgical techniques that decrease the mechanical load of the knee may be effective in treating early primary knee osteoarthritis. Thirtysix consecutive patients with bilateral early primary knee osteoarthritis and genu varum were treated with unilateral proximal tibial osteotomy in the more degenerated knee. After the osteotomized bone healed, ambulation with protected weight bearing using a cane in the contralateral hand was advised continuously for at least three months or until knee pain subsided bilaterally. Thirty-one patients were followed for an average of 4.6 years (range, 2.1-7.8 years). All osteotomized bones healed. Twenty patients (64.5%) had satisfactory knee function bilaterally. Eight patients (25.8%) only had satisfactory knee function in the operated knee. Thus, 28 patients (90.3%) improved operated knee function (p < 0.001). Non-operated knees improved to satisfactory function from 38.7% initially to 71.0% at the latest follow-up (p = 0.01). Bilateral early primary knee osteoarthritis may be successfully treated with unilateral proximal tibial osteotomy.