Knee joint arthroplasty after tibial osteotomy

Abstract

A total of 29 consecutive knee joint arthroplasties in 24 patients who underwent previous high tibial osteotomy (HTO) for medial unicompartment osteoarthritis of the knee and followed up for a mean of 97 months were compared with a control group of 28 patients with 29 primary total knee arthroplasty (TKA) without previous HTO. Results for the osteotomy group were satisfactory in 96.5% of cases. In one patient loosening of the implant occurred after 37 months, which required prosthesis revision. Three patients underwent a further operation of secondary patella resurfacing for patella pain. The group without osteotomy reported a similar percentage of satisfactory results.

High Tibial Osteotomy

“…Additional techniques to facilitate exposure were required in 7 patients being 3 quadriceps snips, 3 lateral releases and 1 tibial tubercle osteotomy. The Caton index was also significantly reduced in the study group post-operatively, in which 3 patients required subsequent patella resurfacing at 18, 19 and 27 months with the authors suggesting that primary patella resurfacing be considered in these patients to reduce rates of anterior knee pain (Amendola 2010).…”

The Mid-Term Outcome of Total Knee Arthroplasty in Patients With Prior High Tibial Osteotomy: A Prospective Study

“…It is generally accepted that TKA after HTO is technically more difficult (10,11); however, there is still disagreement whether the subsequent TKA is compromised. Although several comparative studies showed contradictory results; some (1,2,10,(12)(13)(14) suggesting that prior HTO does not change later TKA outcome and others (5,11,15,16) concluding that the converse is true.…”

“…High tibial osteotomy (HTO) is an established method to treat medial unicompartmental osteoarthritis (OA) of the varus knees in young and middle-aged patients (1)(2)(3)(4). Rationale for the HTO is based on mechanical axis change of the lower limb, with load stress transfer from the pathological medial compartment to the still healthy lateral side (2,5).…”

“…Rationale for the HTO is based on mechanical axis change of the lower limb, with load stress transfer from the pathological medial compartment to the still healthy lateral side (2,5). However, the natural history of following HTO is more or less expected and with longer follow-up, the results worsen.…”

Unikompartmantal diz artroplastisi ve yüksek tibial ostetomi sonrası diz protezi ile revizyon

“…Açık kama osteotomisi sonrasında uygulanacak bir artroplasti için, mediyal parapatellar insizyon yeterli olabilir. [3] Ancak, aynı durum kapalı kama osteotomisi için geçerli değildir. Bu durumda, longitudinal insizyona 60-90º arasında oblik insizyon yapılması ya da çoklu insizyonlar arasında 7 cm'lik aranın korunması, nekroz riski oluşturmadan lateral tibial bölgeye ulaş-maya ve buradaki implantların çıkartılmasına olanak sağlayabilir.…”