Abstract
BackgroundWe performed a matched case control study to assess the effect of prior high tibia valgus producing osteotomy on results and complications of total knee arthroplasty (TKA).MethodsFrom 1996 until 2003 356 patients underwent all cemented primary total knee replacement in our institution. Twelve patients with a history of 14 HTO were identified and matched to a control group of 12 patients with 14 primary TKA without previous HTO. The match was made for gender, age, date of surgery, body mass index, aetiology and type of prosthesis. Clinical and radiographic outcome were evaluated after a median duration of follow-up of 3.7 years (minimum, 2.3 years). The SPSS program was used for statistical analyses.ResultsThe index group had more perioperative blood loss and exposure difficulties with one tibial tuberosity osteotomy and three patients with lateral retinacular releases. No such procedures were needed in the control group. Mid-term HSS, KSS and WOMAC scores were less favourable for the index group, but these differences were not significant. The tibial slope of patients with prior HTO was significantly decreased after this procedure. The tibial posterior inclination angle was corrected during knee replacement but posterior inclination was significantly less compared to the control group. No deep infection or knee component loosening were seen in the group with prior HTO.ConclusionWe conclude that TKA after HTO seems to be technically more demanding than a primary knee arthroplasty, but clinical outcome was almost identical to a matched group that had no HTO previously.
Highlights
We performed a matched case control study to assess the effect of prior high tibia valgus producing osteotomy on results and complications of total knee arthroplasty (TKA)
BMC Musculoskeletal Disorders 2007, 8:74 http://www.biomedcentral.com/1471-2474/8/74 amount of tibia bone stock, tibia plateau tilting, retained osteosynthesis and subacute infection are technical points to be dealt with when performing a total knee arthroplasty (TKA) after proximal tibia osteotomy [2]
No significant differences were noted between the two groups with respect for gender, age, time of follow-up, American Society of Anaesthesiologists (ASA) risk score [22] and type of knee prosthesis ratio (Table 1)
Summary
We performed a matched case control study to assess the effect of prior high tibia valgus producing osteotomy on results and complications of total knee arthroplasty (TKA). BMC Musculoskeletal Disorders 2007, 8:74 http://www.biomedcentral.com/1471-2474/8/74 amount of tibia bone stock, tibia plateau tilting, retained osteosynthesis and subacute infection are technical points to be dealt with when performing a total knee arthroplasty (TKA) after proximal tibia osteotomy [2]. Another important factor influencing the outcome of TKA after HTO is patient selection [3]. Patient cohort disparity may be one of the causes that some report substandard total knee arthroplasty outcome after a high tibial osteotomy [4,5,6] while others see no clinical or radiographic difference for TKA with or without an osteotomy [7,8]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.