Step-cut tibial tubercle osteotomy for access in revision total knee replacement

Broek, C.M. van den; Hellemondt, Gijs G. van; Jacobs, Wilco C. H.; Wymenga, A. B.

doi:10.1016/j.knee.2006.07.003

Cited by 38 publications

(23 citation statements)

References 17 publications

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“…In contrast to previous reports [3,6,16,69,94,99,106], we observed no complications related to the TTO. We identified no extensor mechanism ruptures with either QS or TTO.…”

Section: Discussioncontrasting

confidence: 99%

“…Second, a comparison of all the surgical exposures described [97,104], was not performed for same reason. Third, different fixation techniques of the tibial tubercle [6,26,94,99,101,102,106] were not performed, however, cadaveric studies have shown no differences in failure rate [14,21,22]. The current study can be compared with published studies on the basis of patient demographics (Table 8), clinical results (Table 9), and complications (Table 7).…”

Section: Discussionmentioning

confidence: 95%

“…An 8-to 10-cm osteotomy of the tibial tubercle was made using an oscillating saw ( Fig. 2) with an initial mediolateral cut just scoring the inner side of the lateral cortex, to be completed with osteotomes [94]. Before the saw cut, a step-cut was done at the proximal end of the osteotomy to prevent proximal migration [69,87].…”

Section: Methodsmentioning

confidence: 99%

“…A third wire was passed proximally through the lateral edge of the osteotomized tibial tubercle to impact it under the transverse step-cut osteotomy and prevent proximal migration. Lateral drill holes were placed proximal to the medial drill holes, angling 45°to the shaft, pulling the osteotomy distally [94]. After placement of the stem, the three wires were tightened onto the medial shaft of the tibia (Fig.…”

Section: Methodsmentioning

confidence: 99%

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Tibial Tubercle Osteotomy or Quadriceps Snip in Two-stage Revision for Prosthetic Knee Infection? A Randomized Prospective Study

Bruni

Iacono

Sharma

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Although 7% to 38% of revision total knee arthroplasties (RTKAs) are attributable to prosthetic knee infections, controversy exists regarding the best surgical approach while reducing the risk of extensor mechanism complications and the reinfection rate. Questions/purposes We compared The Knee Society Score Ó (KSS), incidences of complications, maximum knee flexion, residual extension lag, and reinfection rate in patients with prosthetic knee infections treated with two-stage RTKAs using either the tibial tubercle osteotomy (TTO) or the quadriceps snip (QS) for exposure at the time of reimplantation. Methods We prospectively followed 81 patients with chronic prosthetic knee infections treated between 1997 and 2004. Patients were randomized to receive a TTO or QS for exposure at the time of reimplantation. All patients had the same rehabilitation protocol. The minimum followup was 8 years (mean, 12 years; range, 8-15 years). Results Patients in the TTO group had a higher mean KSS than the QS group (88 versus 70, respectively). Mean maximum knee flexion was greater in the TTO group (113°v ersus 94°); with a lower incidence of extension lag (45% versus 13%). We observed no differences in reinfection rate between groups. Conclusions We found the TTO combined with an early rehabilitation protocol associated with superior KSS did not impair extensor mechanism function or increase the reinfection rate. We believe a two-stage RTKA with TTO is a reasonable approach for treating prosthetic knee infections.

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“…In contrast to previous reports [3,6,16,69,94,99,106], we observed no complications related to the TTO. We identified no extensor mechanism ruptures with either QS or TTO.…”

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Tibial Tubercle Osteotomy or Quadriceps Snip in Two-stage Revision for Prosthetic Knee Infection? A Randomized Prospective Study

Bruni

Iacono

Sharma

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…The original arthroplasty was cemented in 78 % of our cases, 66 % were cruciate retaining and the replacement was done after more than five years in 62 % of the cases, all in the same range as other series [4,6,8,9,21,22,32].…”

Section: Discussionmentioning

confidence: 60%

Predictive factors for failure after total knee replacement revision

Luque

Rizo

Urda

et al. 2014

International Orthopaedics (SICOT)

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Purpose We used the Optetrak Condylar Constrained (CCK) implant, a modular and constrained knee implant as replacement for a failed primary arthroplasty, to assess the survivorship, the complications, the clinical, radiological, and functional situation, and the quality of life of those patients in whom a CCK had been implanted in recent years in order to find predictive pre-operative conditions of survival and clinical outcomes. Methods We performed a retrospective study of 125 CCK implanted between 1999 and 2005. The mean follow-up was nine years (range, seven to 13). Mean age was 73.6 years. A total of 78 % of the revised TKA were cemented and 66 % were CR. We assessed the pre-operative, the operative and the postoperative conditions studying the medical files of all the patients. In order to study the functional and clinical situation we used the Hospital for Special Surgery (HSS) score and the Knee Society score (KSS), both clinical and functional. We analysed all the X-rays using the Knee Society Roentgenographic evaluation. The quality of life was studied using the Oxford knee score (OKS). Results The mean results of the KSS clinical and the KSS functional were 68.24 and 63.85, respectively. There were not any conditions associated with poor results of the knees (p>0.05). The global survival at 24 months was 92.7 %, at 60 months 87.8 % and at 96 months it was 87.8 %. There were some conditions associated with poor survival of the knees, e.g. patients were younger than 70 years old, rheumatic diseases, kidney faliure, tibial tuberosity osteotomy, PS primary arthroplasty, revision before five years and septic loosening.Conclusions Based on these results there are some preoperative factors that change the survival of the total knee replacement revision.

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