EC Orthopaedics

Introduction: Gonarthrosis is a frequent degenerative pathology, and is particularly incapacitating. Tibial valgization osteotomy (TVO) is a therapeutic option for young, active patients with unicompartmental osteoarthritis of the medial compartment of the knee.

Materials and Methods: We conducted a retrospective descriptive and analytical study over a 5-year period from January 1, 2019 to December 31, 2024.

Results: During our study, 20 cases of tibial valgization osteotomy were recorded out of a total of 2066 admissions (i.e. 0.9%), and we studied the sociodemographic characteristics, diagnostic and evolutionary aspects of these patients. In our study, 70% of patients were female. The mean age of patients was 47.6 years, with extremes of 18 and 64 years. Trauma was the most common risk factor in 30% of cases, 60% of patients were sedentary and 50% had already undergone infiltration. Clinical examination revealed gonalgia, deformity and lameness in 95%, 85% and 80% of cases respectively; bilateral varum knee in 70% of cases, and meniscal syndrome in 5% of cases. The Schuss index was present in 15% of cases, and patients were classified as stage III according to the Ahlbäck and Iwano classifications in 85% of cases each. The approach was the medial Gernez in 85% of cases, the implant was a T-plate in 90% and the surgical treatment was a reduction in 95% of cases. Post-operative follow-up was straightforward in 90% of cases, with the onset of weight-bearing at 45 days in all patients. Phlebitis and stiffness were the most common long-term complications, occurring in 5% of cases. There was a statistically significant association between the intraoperative use of a T-plate and easy post-operative recovery (p = 0.04).

Conclusion: OTV remains an effective alternative in the management of medial gonarthrosis, providing pain relief and improved joint functionality. However, multidisciplinary management and rigorous follow-up are required to optimize results and prevent complications.

 Keywords: Tibial Valgization Osteotomy; Department of Orthopaedic Surgery and Traumatology-General Hospital of Reference; Niamey; Niger

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