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Long-term results of total knee arthroplasty following high tibial osteotomy according to Wagner

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There is relatively little information available about the long-term results of total knee arthroplasty (TKA) following high tibial osteotomy. The aim of our study was to share our experiences and long-term results of TKA after a previous closing wedge high tibial osteotomy according to Wagner.


In a retrospective study we identified 48 consecutive patients who had undergone TKA after a previous closing wedge high tibial osteotomy according to Wagner with a follow-up of over ten years. The average duration of follow-up after the TKA was 13.3 years (min 10.0, max 15.5). X-rays were taken in two planes before TKA, one week after TKA and at the latest follow-up. Tibio-femoral alignment was measured on weightbearing long-leg anteroposterior radiographs. Radiolucent lines at the latest follow-up were documented. Functional evaluations were performed preoperatively and postoperatively (at the time of latest follow-up).


The mean Knee Society function score increased from 63.1 points preoperatively to 90.0 points postoperatively. The mean overall Knee Society score increased from 93.2 points preoperatively to 160.8 points postoperatively. The mean average femoro-tibial angle was corrected from varus 0.8° (varus 14°–valgus 8.0°) preoperatively to valgus 7.6° (valgus 2–9°) at the last follow-up.


The closing wedge high tibial osteotomy according to Wagner does not compromise subsequent total knee replacement and leads to good clinical and radiological results.

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  1. Kosashvili Y, Safir O, Gross A, Morag G, Lakstein D, Backstein D (2010) Distal femoral varus osteotomy for lateral osteoarthritis of the knee: a minimum ten-year follow-up. Int Orthop 34:249–254

    Article  PubMed  Google Scholar 

  2. van Raaij TM, Bakker W, Reijman M, Verhaar JA (2007) The effect of high tibial osteotomy on the results of total knee arthroplasty: a matched case control study. BMC Musculoskelet Disord 8:74

    Article  PubMed  Google Scholar 

  3. Madan S, Ranjith RK, Fiddian NJ (2002–2003) Total knee replacement following high tibial osteotomy. Bull Hosp Jt Dis 61(1–2):5–10

    Google Scholar 

  4. Cameron HU, Park YS (1996) Total knee replacement following high tibial osteotomy and unicompartmental knee. Orthopedics 19(9):807–808

    PubMed  CAS  Google Scholar 

  5. Bae DK, Song SJ, Yoon KH (2010) Total knee arthroplasty following closed wedge high tibial osteotomy. Int Orthop 34(2):283–287

    Article  PubMed  Google Scholar 

  6. Kazakos KJ, Chatzipapas C, Verettas D, Galanis V, Xarchas KC, Psillakis I (2008) Mid-term results of total knee arthroplasty after high tibial osteotomy. Arch Orthop Trauma Surg 128(2):167–173

    Article  PubMed  Google Scholar 

  7. Wagner H, Zeiler G, Baur W (1985) Indication, technic and results of supra- and infracondylar osteotomy in osteoarthrosis of the knee joint. Der Orthopade 14(3):172–192

    PubMed  CAS  Google Scholar 

  8. Baur W, Hönle W, Schuh A (2005) Proximal tibial osteotomy for osteoarthritis of the knee with varus deformity. Oper Orthop Traumatol 17(3):326–344

    Article  PubMed  Google Scholar 

  9. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthrosis. Ann Rheum Dis 16:494–502

    Article  PubMed  CAS  Google Scholar 

  10. Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    PubMed  Google Scholar 

  11. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  12. Amendola L, Fosco M, Cenni E, Tigani D (2010) Knee joint arthroplasty after tibial osteotomy. Int Orthop 34(2):289–295

    Article  PubMed  Google Scholar 

  13. Windsor RE, Insall JN, Vince KG (1988) Technical considerations of total knee arthroplasty after proximal tibial osteotomy. J Bone Joint Surg Am 70(4):547–555

    PubMed  CAS  Google Scholar 

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Correspondence to Alexander Schuh.

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Treuter, S., Schuh, A., Hönle, W. et al. Long-term results of total knee arthroplasty following high tibial osteotomy according to Wagner. International Orthopaedics (SICOT) 36, 761–764 (2012).

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