Knee Surg Relat Res.  2016 Jun;28(2):89-98. 10.5792/ksrr.2016.28.2.89.

Conversion Total Knee Arthroplasty after Failed High Tibial Osteotomy

Affiliations
  • 1Department of Orthopedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea. bdkyung@khmc.or.kr

Abstract

Clinical results of high tibial osteotomy (HTO) deteriorate over time despite the initial satisfactory results. Several knees may require a conversion to total knee arthroplasty (TKA) because of failure such as the progression of degenerative osteoarthritis and the loss of the correction angle. It is important to know the long-term survival rate and common reason of failure in HTO to inform patients of postoperative expectations before surgery and to prevent surgical errors during surgery. In addition, it has been reported that clinical and radiological results, revision rate, and complication rate were poorer than those in patients without a previous HTO. There are few review articles that describe why conversion TKA after HTO is surgically difficult and the results are poor. Surgeons have to avoid the various complications and surgical errors in this specific situation. We would like to present the considering factors and technical difficulties during conversion TKA after HTO with a review of the literature. We could conclude through the review that the correction of deformity, lower amount of tibial bone resection, and sufficient polyethylene insert thickness, restoration of the joint line height, and adequate ligament balancing can be helpful in overcoming the technical challenges encountered during TKA following HTO.

Keyword

Knee; Osteoarthritis; Osteotomy; Arthroplasty

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee*
Congenital Abnormalities
Humans
Joints
Knee
Ligaments
Medical Errors
Osteoarthritis
Osteotomy*
Polyethylene
Surgeons
Survival Rate
Polyethylene
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