Abstract
To The Editor: I read with interest “Total Knee Arthroplasty Following Proximal Tibial Osteotomy: Risk Factors for Failure” (2004;86:474-9) by Parvizi et al. The authors reviewed the results of 166 cemented condylar knee replacements done in 118 patients who had previously had a proximal tibial osteotomy. These knee replacements had relatively inferior results, and the authors identified risk factors for early failure. The problems cited by the authors were malalignment, patella baja, instability, periarticular scarring, proximal tibial bone deficiency, and retained hardware. The great detail about the knee arthroplasty, the long follow-up, and the meticulous study design are all severely compromised by the absence of any detail regarding the technique of osteotomy. Were these opening or closing wedge corrections? Was the fibula osteotomized or was the proximal tibiofibular joint sprung? Was there internal, external, or no fixation? Were casts applied or were … Corresponding author: Mark J. Spangehl, MD Mayo Clinic 13400 East Shea Boulevard Scottsdale, AZ 85259
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