The study of Maquet dome high tibial osteotomy. Arthroscopic-assisted analysis.

A review of 118 Maquet valgus high tibial osteotomies, secured with Charnley's external compression fixator, included 110 cases of primary osteoarthritis, six cases of osteonecrosis, and two cases of traumatic arthritis. Preoperatively, the mechanical axis of alignment showed varus deformity with an average of 9.6 degrees, while the final follow-up evaluation demonstrated valgus alignment with an average of 4.7 degrees. According to the criteria of Insall et al. the knee scores improved from 63.3 preoperatively to 88.8 postoperatively. The results were excellent or good in 84.8% of 118 knees followed an average of 27 months (range, 12-84 months). A significant relationship existed between the success of the correction of the mechanical axis and the knee's functional result. Also, the severity of the preoperative coronal angular deformity of the knee joint had a negative relationship with the final knee function. There were 39 (33.1%) complications, including 13 recurrences of varus deformity, 13 pin-tract infections, five peroneal nerve palsies, and two paralyses of the extensor hallucis longus. Preoperative arthroscopic grading according to the criteria of Fujisawa et al. and the additional point-counting method did not adequately predict the knee's functional outcome, but postoperative arthroscopic grading was of some prognostic value.