Total Knee Arthroplasty after a Proximal Tibial Osteotomy

Abstract

Introduction The result of total knee replacement (TKR) after proximal tibial osteotomy performed to treat unicompartmental knee osteoarthritis is a highly relevant issue given the widespread use made nowadays of unicompartmental knee prostheses. This is a retrospective comparative study carried out to determine whether the presence of a previous osteotomy negative influences the result of TKRs. Materials and methods Of all the patients subjected to TKR in our hospital, we selected a series of 20 cases that had a prior proximal tibial osteotomy and we compared them with a group of patients with a primary PTR, which we used as control. We performed a series of radiographic (patellar height, alignment of the knee axis and thickness of the tibial section) and clinical (joint mobility, walking capability and complications) measurements, in order to compare both groups and establish differences between them. Mean follow-up was 5 years. Results No differences were found in the measurements taken with respect to the varus/valgus index or the functional result achieved. We did observe, however, a slight decrease in patellar height as well as an increase in OR time and in the technical complexity of the procedure. We also detected a relative bone stock deficit in patients who had undergone a previous proximal tibial osteotomy. Conclusion High tibial osteotomy remains a reliable treatment for unicompartmental knee osteoarthritis. It is a procedure surgeons have vast experience of and which does not negatively influence a potential TKR implantation at a later date.