Incidence of osteotomies around the knee for the treatment of knee osteoarthritis: a 22-year population-based study.

PURPOSE: Both tibial and femoral osteotomies have been used for the treatment of knee osteoarthritis (OA). Due to the clinical success of total knee arthroplasty (TKA) the current role and incidence of osteotomies remains unknown. The aim of this population-based study was to assess the incidence of osteotomies and compare it with that of knee arthroplasties.

METHODS: From the Finnish National Hospital Discharge Register, we identified all patients, aged 18 years or more, who had undergone osteotomy for the treatment of knee OA between 1987 and 2008. The number of arthroplasties was extracted from the Arthroplasty Register.

RESULTS: A total of 6,004 osteotomies were performed for 5,734 patients. The average osteotomy incidence has steadily decreased by 6.2%, and TKA incidence has increased by 9.8% annually. However, in patients aged less than 50 years the osteotomy incidence has increased by 1.4% annually. The decline of osteotomy incidence has been steeper in females than in males (9.0% vs. 3.6%), and during the last decade osteotomies were more commonly performed in male patients.

CONCLUSION: Incidence of osteotomies for the treatment of knee OA has decreased during last two decades. However, in patients aged less than 50 years the osteotomy incidence has slightly increased. In a comparison by gender, females are more likely to undergo arthoplasty than osteotomy, and it would therefore appear that the current use of osteotomies is predominantly reserved for the treatment of knee OA in relatively young males.