A severely overcorrected high tibial osteotomy Revision by osteotomy and a long stem component

Uchinou, Shouichi; Yano, Hirokazu; Shimizu, Kunio; Masumi, Shôgo

doi:10.3109/17453679608994671

Cited by 9 publications

(5 citation statements)

References 3 publications

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“…Also in this patient, we supposed that the delay of the clinical presentation was In this case, the tibia was reamed thoroughly up to 17 mm by machine reamer to fix the osteotomized site by cementless press-fit extension-stem only. The decision to use cement or cementless fixation of the extended stem should also be considered [8,12]. We consider the use of a press-fit extension-stem enough to fix an osteotomized tibia.…”

Section: Discussionmentioning

confidence: 99%

Thermal necrosis after simultaneous tibial osteotomy and total knee arthroplasty using press-fit extension-stem

Ishida

Tsumura

Takayama

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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One-staged tibial corrective osteotomy and total knee arthroplasty is a challenging but effective treatment for arthritic knees with extra-articular deformity. Although osteocutaneous thermal necrosis is accepted as a complication of intramedullary reamed nailing following long bone fractures, only 15 cases have been reported in the English literature at present. This report illustrates a rare case of thermal necrosis in a patient undergoing tibial corrective osteotomy coincident with long-stemmed total knee arthroplasty. Excessive reaming with a machine reamer is hypothesized as the cause of this serious complication. In this report, we highlight this rare but serious complication after long-stemmed total knee arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Thermal necrosis after simultaneous tibial osteotomy and total knee arthroplasty using press-fit extension-stem

Ishida

Tsumura

Takayama

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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“…Zanone et al [5] treated four knees with stages III-IV arthrosis and pre-operative varus > 17°( mFTA 158-163º), with a medial-opening wedge HTO associated with TKA. At an average follow-up of 11 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) months, they reported one case of undercorrection and no nonunions. Of ten patients in their study, Radke and Radke [17] reported KSS improvement of 28 ± 15.25-80.60 ± 15.94.…”

Section: Technical Sequencementioning

confidence: 94%

“…b Nonunion at 8 months. c Osteotomy graft and lockingplate fixation The third option is to combine valgising tibial osteotomy with TKA as a single-stage procedure, allowing correction of the frontal-plane deformity without the need for extensive medial soft tissue release and maintaining the level of the joint line [15]. We prefer medial-opening wedge osteotomy to lateral-closing wedge procedure in this case, approaching the deformity from the side of the concavity and avoiding release of structures on the convexity.…”

Section: Surgical Sequencementioning

confidence: 95%

Results and complications of single-stage total knee arthroplasty and high tibial osteotomy

Madelaine

Villa

Yela

et al. 2014

International Orthopaedics (SICOT)

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“…Наиболее частым исходом после неудачной корригирующей остеотомии является эндопротезирование коленного сустава. Проблема эндопротезирования после неудачной ВТО затронута в большинстве источников мировой литературы, однако имеются редкие упоминания клинических случаев ревизионных остеотомий, связанных с гиперкоррекцией [3][4][5][6].…”

Section: обоснованиеunclassified

Excessive hypercorrection after an open wedge high tibial osteotomy: a clinical case

Prizov

Zagorodnij

Nikitin

et al. 2022

Journal of Clinical Practice

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Introduction Currently there is a tendency of increasing the proportion of knee joint organ-preserving surgery. High tibial osteotomy (HTO) was recommended as a method of knee joint varus deformity treating in cases with extraarticular deformity. The question of necessary angle correction remains controversial, which does not harm biomechanics of knee and adjacent joints. And the issue of preventing excessive hypercorrection as a complication of osteotomy. Methods The clinical case of the 59-year-old patient who underwent primary HTO and revision HTO is analyzed in this article. The patient had a varus deformity of a left lower limb with isolated medial knee osteoarthritis. The patient complained only at pain and range of motion limitation in the knee joint. According to arthroscopy and magnetic resonance imaging (MRI) data, there was cartilage damage classified as Outerbridge 4 stage of the medial compartment. There were no signs of lateral compartment cartilage damage and patellofemoral joint arthritis. The patient's body mass index (BMI) was 28kg / m2. Varus deformity of the knee joint 10˚. Results The patient underwent a medial high tibial open wedge osteotomy. During preoperative planning topograms of the lower limb with a weight bearing were used. A clinical result before the operation according to the scales was: Knee injury and Osteoarthritis Outcome Score (KOOS) 46 points, Visual Analogue Scale (VAS) 7 cm., American Orthopaedic Foot and Ankle Society (AOFAS) 92 points. After 6 months from initial surgery: knee joint VAS 1 cm., ankle joint VAS 5 cm., KOOS 88 points, AOFAS 63 points. During clinical examination and according to instrumental studies, excessive valgus hypercorrection of the 11,2˚ noted. Also, tibial plafond inclination (TPI) and talar inclination (TI) significantly increased. 1,5 years after the primary osteotomy, a revision closed wedge osteotomy was performed. Valgus deformity of the knee joint became 3˚, axis of the ankle joint changed to normal values. Clinical and functional results after 6 months after revision osteotomy: KOOS 92 points, AOFAS 99 points, pain in the knee and ankle joint on the VAS scale 1 cm. Conclusions The case showed: careful preoperative planning before the operation and using of additional methods for monitoring intraoperative correction were important. Excessive valgus hypercorrection promotes good regeneration of the medial compartment cartilage, however it overloads a lateral compartment and adversely affects the ankle joint and foot.

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A severely overcorrected high tibial osteotomy Revision by osteotomy and a long stem component

Cited by 9 publications

References 3 publications

Thermal necrosis after simultaneous tibial osteotomy and total knee arthroplasty using press-fit extension-stem

Thermal necrosis after simultaneous tibial osteotomy and total knee arthroplasty using press-fit extension-stem

Results and complications of single-stage total knee arthroplasty and high tibial osteotomy

Excessive hypercorrection after an open wedge high tibial osteotomy: a clinical case

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