{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:05:43Z","timestamp":1783649143661,"version":"3.55.0"},"reference-count":35,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"5","license":[{"start":{"date-parts":[[2016,5,1]],"date-time":"2016-05-01T00:00:00Z","timestamp":1462060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>In arthritis of the varus knee, a high tibial osteotomy (HTO) redistributes load from the diseased medial compartment to the unaffected lateral compartment.<\/jats:p><jats:p>We report the outcome of 36 patients (33 men and three women) with 42 varus, arthritic knees who underwent HTO and dynamic correction using a Garches external fixator until they felt that normal alignment had been restored. The mean age of the patients was 54.11 years (34 to 68). Normal alignment was achieved at a mean 5.5 weeks (3 to 10) post-operatively. Radiographs, gait analysis and visual analogue scores for pain were measured pre- and post-operatively, at one year and at medium-term follow-up (mean six years; 2 to 10). Failure was defined as conversion to knee arthroplasty.<\/jats:p><jats:p>Pre-operative gait analysis divided the 42 knees into two equal groups with high (17\u00a0patients) or low (19 patients) adductor moments. After correction, a statistically significant (p &lt; 0.001, t-test,) change in adductor moment was achieved and maintained in both groups, with a rate of failure of three knees (7.1%), and 89% (95% confidence interval (CI) 84.9 to 94.7) survivorship at medium-term follow-up.<\/jats:p><jats:p>At final follow-up, after a mean of 15.9 years (12 to 20), there was a survivorship of 59% (95% CI 59.6 to 68.9) irrespective of adductor moment group, with a mean time to conversion to knee arthroplasty of 9.5 years (3 to 18; 95% confidence interval \u00b1 2.5).<\/jats:p><jats:p>HTO remains a useful option in the medium-term for the treatment of medial compartment osteoarthritis of the knee but does not last in the long-term.<\/jats:p><jats:p>Cite this article: Bone Joint J 2016;98-B:601\u20137.<\/jats:p>","DOI":"10.1302\/0301-620x.98b5.34875","type":"journal-article","created":{"date-parts":[[2016,5,3]],"date-time":"2016-05-03T10:07:42Z","timestamp":1462270062000},"page":"601-607","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Medium- and long-term results of high tibial osteotomy using Garches external fixator and gait analysis for dynamic correction in varus osteoarthritis of the knee"],"prefix":"10.1302","volume":"98-B","author":[{"given":"D.","family":"McClelland","sequence":"first","affiliation":[{"name":"Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent ST4 6QG, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Barlow","sequence":"additional","affiliation":[{"name":"Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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