Comparison of total knee arthroplasty after combined high tibial osteotomy with a matched group of primary total knee arthroplasty
Miklós Papp1, Zsolt Zsákai1, András Gömöri2
1Department of Orthopaedic Surgery, Borsod County Teaching Hospital, Miskolc, Hungary
2Department of Traumatology, Borsod County Teaching Hospital, Miskolc, Hungary
Keywords: Clinical scoring systems of The Knee Society, matched groups, primary total knee arthroplasty, total knee arthroplasty after combined high tibial osteotomy.
Objectives: This study aims to compare the results of total knee arthroplasties (TKAs) performed after previous combined high tibial osteotomy (CO) to those of a matched control group of primary TKA.
Patients and methods: Between 01 August 2006 and 31 December 2011, we performed 24 consecutive cemented TKAs in 24 patients (10 males, 14 females; mean age 69.5 years; range, 60 to 79 years) who had undergone previous CO (study group). The study group was compared to a control group of 24 patients (10 males, 14 females; mean age 69.9 years; range, 63 to 79 years) who were performed primary TKA during the same period. Pre- and postoperative The Knee Society knee and function score and range of movement were determined. The femorotibial angle, the distance between the tangent to the lateral subchondral plate and the top of the fibular head, the transposition of the tibial condyle, the length of the patellar tendon and the tibial slope angle were measured preoperatively. At final follow-up, the same parameters were calculated and the amount of lateral tibial bone resection was determined.
Results: The mean follow-up duration was 97 months (range, 61 to 124 months) in the study group and 97 months (range, 61 to 123 months) in the control group. TKA survivorship rate was 100% in both groups. At final follow-up, there were no significant differences regarding the clinical and radiographic data. However, only the amount of the resected lateral bone was significantly lower in the study group than in the control group.
Conclusion: In young and active people with medial knee arthrosis, in whom the planned correction is 10° or higher, we continue to suggest CO since it does not seem to influence the results of TKA negatively.