Total knee arthroplasty after distal femoral osteotomy: a systematic review and current concepts

Abstract

Introduction: Distal Femoral Osteotomy (DFO) is a common procedure for correcting lower limb valgus deformity and lateral compartment overload. Low 20-year survivorship rate was reported with a consequent need for total knee arthroplasty (TKA). This study aims to review literature and to analyse the influence of a previous distal femoral osteotomy on outcomes of patients undergoing TKA. Methods: A systematic literature review was performed in PubMed/Medline and Embase in May 2020. Papers were selected based on the following criteria: patient with a previous distal femoral osteotomy; total knee replacement; Pre- and Postoperative outcomes; surgical outcomes: clinical scores, range of motion, radiographic evaluation and revisions for any cause; case series, retrospective studies, observational studies, open-label studies, randomized clinical trials; systematic reviews and meta-analyses were included to extract primitive studies. Results: 306 articles were found, of which five papers were considered eligible for this review. In every study included, postoperative clinical outcomes (Knee Society Score or Hospital for Special Surgery score) statistically improved from the preoperative. Complications were not uncommon; implant survivorship at the available follow-up seems to be similar to primary TKA, although being too short to draw any conclusions. Conclusions: Limited and highly heterogeneous evidence is currently available on the influence of DFO on outcomes after TKA. Knee replacement improves clinical middle-term outcomes in patients with previous distal femoral osteotomy. In this complex surgery, the use of technical tips and tricks could help surgeons to obtain an accurate knee balancing and better long-term results.

Prior medial meniscus arthroscopy is not associated with worst functional outcomes in patients undergoing primary total knee arthroplasty: A retrospective single-center study with a minimum follow-up of 5 years

“…It has been reported that previous open knee interventions like high tibial osteotomies are correlated with inferior functional and clinical outcomes in patients undergoing TKA when compared with those of primary TKA without previous procedures [16][17][18]. Moreover, TKA patients with prior anterior cruciate ligament (ACL) reconstruction have also exhibited inferior outcomes.…”

Surgical Treatment of Patients With Knee Pathology and Deformities of the Lower Extremities: А Systematic Review

“…Недостатком этого обзора было то, что во всех публикациях анализировалось небольшое количество пациентов. Тем не менее авторы сделали вывод о том, что предыдущая правильно выполненная остеотомия не влияет на клинические исходы первичного эндопротезирования, результаты которого сопоставимы с результатами эндопротезирования без предшествующей остеотомии [51].…”

Is standard total knee arthroplasty with lateral femoral overhanging a cause of anterior knee pain? A randomized controlled trial

“…Total knee arthroplasty (TKA) has shown good outcomes and survivorship [1][2][3][4][5]. However, postoperative anterior knee pain (AKP) is a common problem after TKA and affects patient satisfaction [6][7][8][9].…”