Realignment is a crucial step in the surgical treatment of patients with varus, where it is desirable to postpone the arthroplasty. The tibial valgus osteotomy (TVO) in combination with microfracture reportedly lead to lower functional outcomes than TVO alone in knee OA patients with a varus deformity.

Tibial Valgus Osteotomy (TVO) is a surgical treatment of angular deviations of varum in the medial compartment of knee osteoarthritis patients. In short and long terms, the effects of TVO has not been extensively assessed. This study aimed to evaluate the outcomes of microfracture intervention in patients who have undergone TVO.

Total 129 patients with medial gonarthrosis, varus deformity and range of movements more than 90⁰ were included in this study. Exclusion criteria were previous knee surgery, BMI>35 kg/m², having cruciate ligament injuries and Outerbridge lesion inferior to IV. Videoarthoscopy was used to treat patients, followed by TVO. Group I (n=56) had undergone TVO with microfracture intervention, whereas in group II (n=73), only TVO was performed. Evaluations were done for 24 months after surgery, with four assessments in the first six months and two evaluations per year after that.

In group II, there was a considerable improvement in pain and limping, whereas in group I, results variance was very high with an increased risk of functional deterioration.

Microfracture intervention in TVO association was reported to result in lower functional outcomes as compared to TVO alone.