Abstract
Introduction: There is only little information available about total knee arthroplasty (TKA) following distal femoral varus osteotomy (DFVO). The aim of our study was to show our experiences and mid-term results of TKA after a previous DFVO. Material and method: In a retrospective study we identified 36 consecutive patients who had undergone TKA after a previous distal femoral varus osteotomy. The average duration of follow-up after the TKA was 8.2 years (min: 5.0, max: 9.2). X-rays were taken in 2 planes before TKA, 1 week after TKA and at latest follow-up. Tibiofemoral alignment was measured on weightbearing long-leg anteroposterior radiographs. Ra- diolucent lines at latest follow-up were documented. Functional evaluations were performed preoperatively and postoperatively (at the time of latest follow-up). Results: The mean Knee Society knee score in- creased from 42 points before the arthroplasty to 91.3 points after the arthroplasty. The mean Knee Society function score increased from 27.4 points preoperatively to 93.2 points postoperatively. The mean overall Knee Society score increased from 91.3 points preoperatively to 163.4 points postoperatively. The mean radiographic alignment was 4.5? of valgus (10? of varus to 19? of valgus) before TKA and 3.1? of valgus (range, 3? of varus to 6? of valgus) at the time of latest follow-up. Postoperative complications included one deep vein thrombosis with non-lethal pulmonary embolism, one wound infection requiring revision and one septic loosening. Discussion: It is possible to perform TKA following DFVO with good mid-term results. In comparison to the literature there is no higher risk of complications in TKA following DFVO in comparison to primary TKA.
Highlights
There is only little information available about total knee arthroplasty (TKA) following distal femoral varus osteotomy (DFVO)
Several studies reported good outcomes lasting more than a decade for patients with varus deformity treated by high valgus tibial osteotomy in appropriately selected patients
For a valgus deformity of more than 12 ̊ or in situations where the plane of the joint is deviated from the horizontal by more than 10 ̊, a distal femoral varus osteotomy (DFVO) should be preferred 1
Summary
There is only little information available about total knee arthroplasty (TKA) following distal femoral varus osteotomy (DFVO). Material and method: In a retrospective study we identified 36 consecutive patients who had undergone TKA after a previous distal femoral varus osteotomy. The mean Knee Society function score increased from 27.4 points preoperatively to 93.2 points postoperatively. The mean overall Knee Society score increased from 91.3 points preoperatively to 163.4 points postoperatively. A recent study indicated good mid-term success rates of DFVO even in the presence of moderate patellofemoral arthritis at a mean follow-up of 99 months 3. Edgerton et al 4 reported on 23 patients (24 knees managed with DFVO) and found 71% with good or excellent results at a mean follow-up of 8.3 years. There have been reports of technical difficulties after
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