Archives of Orthopaedic and Trauma Surgery

, Volume 128, Issue 2, pp 167–173

Mid-term results of total knee arthroplasty after high tibial osteotomy

  • Konstantinos J. Kazakos
  • Christos Chatzipapas
  • Dionysios Verettas
  • Vasilios Galanis
  • Konstantinos C. Xarchas
  • Ioannis Psillakis
Orthopaedic Surgery

DOI: 10.1007/s00402-007-0488-3

Cite this article as:
Kazakos, K.J., Chatzipapas, C., Verettas, D. et al. Arch Orthop Trauma Surg (2008) 128: 167. doi:10.1007/s00402-007-0488-3

Abstract

Background

The outcome of total knee arthroplasty (TKA) after high tibial osteotomy (HTO) is still controversial. In order to determine if osteotomy has any effect on this outcome we performed a medium-term review of a cohort of patients with knee osteoarthritis.

Materials and methods

Thirty-two patients (38 knees), who were treated with a HTO before the TKA during the last 8 years, were compared with a matched group who underwent primary TKA. The knees were evaluated preoperatively and postoperatively according to the scoring systems of the Knee Society and Hospital for Special Surgery (HSS). The anteroposterior tibiofemoral alignment, the Insall–Salvati patellar position ratio, range-of-motion and the location of the lateral joint line, were also recorded. The patients were reviewed with a mean follow-up of 4.5 years after TKA.

Results

The preoperative and postoperative knee scores had no statistically significant differences between the two groups. So was the case with the intraoperative releases, blood loss, thromboembolic or neurologic complications and infection rates in either group. Access to perform the arthroplasty was reportedly more difficult and took an average of 25 min longer. A significant difference (p < 0.05) was detected in terms of impingement of the tibial stem on the lateral tibial cortex, patellar subluxation and patella baja between the two groups but this did not have any influence on the outcome of the prosthesis. Knee alignment and stability so as range of motion (ROM) measurements were also found with no statistical significance.

Conclusion

Although we did manage to detect statistically significant differences mainly in radiographic results between the two groups, this situation did not appear to influence the clinical outcome of the patients, however. The fact that most of the patients had good or excellent results at an average follow-up of 4.5 years suggests that HTO does not have a significant negative effect on later TKA.

Keywords

Osteoarthritis Knee arthroplasty High tibial osteotomy 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Konstantinos J. Kazakos
    • 1
  • Christos Chatzipapas
    • 1
  • Dionysios Verettas
    • 1
  • Vasilios Galanis
    • 1
  • Konstantinos C. Xarchas
    • 1
  • Ioannis Psillakis
    • 1
  1. 1.Department of OrthopaedicsDemocritus University of Thrace, University Hospital of AlexandroupolisAlexandroupolis PCGreece