High tibial osteotomy in the treatment of osteoarthritis of the knee. The role of preoperative arthroscopy.

Sixty osteoarthritic knees that were evaluated by arthroscopic, radiographic, and clinical (Insall knee-rating scale) examination prior to high tibial valgus osteotomy were re-evaluated radiographically and clinically after a minimum follow-up of two years. After two and three years, the clinical scores of the knees with bicompartmental and tricompartmental osteoarthritis (including exposed subchondral bone in the lateral compartment) were the same as the scores of the knees with unicompartmental disease. The scores of the knees with 5 to 13 degrees of valgus alignment at two years were significantly higher (p less than 0.01) than the scores of the knees with less than 5 degrees of valgus angulation, regardless of the arthroscopy scores. Based on the results after two to three years, the arthroscopic findings prior to osteotomy appeared to have little, if any, predictive value in evaluating patients for this procedure.