Total Knee Arthroplasty After Failed High Tibial Osteotomy

Haslam, Paul; Armstrong, Michael F.; Geutjens, Guido; Wilton, Timothy

doi:10.1016/j.arth.2006.01.031

Cited by 67 publications

(76 citation statements)

References 20 publications

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“…They also found use of stemmed implants similar to that in our study. Some independent studies with small numbers of patients have found equal outcome in TKA patients operated after HTO and in patients with a primary TKA regarding functional outcome and survival (Meding et al 2000), or functional measures only (Treuter et al 2012), whereas other studies have indicated more failures with higher reoperation rates (Parvizi et al 2004, Haslam et al 2007). …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, some patients later require a second procedure, a total knee arthroplasty (Naudie et al 1999), depending on the degree of osteoarthritis, their level of pain and function, and the degree of correction achieved. Although total knee arthroplasty appears to be technically more challenging after HTO in cases with severe overcorrection, bone stock loss, altered joint line (Figures 1 and 2), or patella infera, only a few studies have found inferior results compared to primary TKA (Windsor et al 1988, Parvizi et al 2004, Haslam et al 2007, Farfalli et al 2012). The aim of this study was to evaluate the risk of revision after TKA, comparing primary TKA with and without previous high tibial osteotomy using data from the Norwegian Arthroplasty Register (NAR).…”

mentioning

confidence: 99%

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The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

Badawy¹,

Fenstad²,

Indrekvam³

et al. 2015

Acta Orthopaedica

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Background and purpose — Previous studies have found different outcomes after revision of knee arthroplasties performed after high tibial osteotomy (HTO). We evaluated the risk of revision of total knee arthroplasty with or without previous HTO in a large registry material.Patients and methods — 31,077 primary TKAs were compared with 1,399 TKAs after HTO, using Kaplan-Meier 10-year survival percentages and adjusted Cox regression analysis.Results — The adjusted survival analyses showed similar survival in the 2 groups. The Kaplan-Meier 10-year survival was 93.8% in the primary TKA group and 92.6% in the TKA-post-HTO group. Adjusted RR was 0.97 (95% CI: 0.77–1.21; p = 0.8).Interpretation — In this registry-based study, previous high tibial osteotomy did not appear to compromise the results regarding risk of revision after total knee arthroplasty compared to primary knee arthroplasty.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

Badawy¹,

Fenstad²,

Indrekvam³

et al. 2015

Acta Orthopaedica

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“…The vast majority of these data deal with outcomes of TKA after conversion from lateral closingwedge HTOs. Although somewhat conflicting, recent data indicate lateral closing-wedge HTOs converted to TKA perform as well as primary TKAs [4,10]. Only one study exists comparing short-term functional outcomes of converted medial opening-wedge HTO to primary TKA.…”

Section: Introductionmentioning

confidence: 99%

“…Survivorship of TKA after conversion from HTO has also come into question in the literature. A study by Haslam et al [4] suggested a trend toward poorer survivorship of converted lateral closing-wedge HTOs at 12 years when compared to primary TKA. However, no statistically significant difference was found.…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, degenerative changes in the knee tend to progress despite initially successful realignment procedures and some HTOs are converted to TKA. However, given that the mechanical and anatomic axes of the tibia have been altered in these patients, performance of arthroplasty after HTO has been extensively reviewed in the literature [1,3,4,6,7,9,10]. The vast majority of these data deal with outcomes of TKA after conversion from lateral closingwedge HTOs.…”

Section: Introductionmentioning

confidence: 99%

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Total Knee Arthroplasty After High Tibial Osteotomy: No Differences Between Medial and Lateral Osteotomy Approaches

Preston

Howard

Naudie

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background High tibial osteotomy (HTO) has long been accepted as an effective treatment for unicompartmental osteoarthritis of the knee in young, active adults. For varus knees, the two most commonly performed valgus-producing HTOs are the lateral closing wedge and the medial opening wedge. Regardless of technique, some HTOs fail and are converted to TKA. To our knowledge, no studies have directly compared TKAs done after lateral closingwedge osteotomies to those done after medial openingwedge osteotomies. Questions/purposes We compared pain-and functionrelated outcomes and survivorship of TKAs in patients who previously underwent medial opening-wedge and lateral closing-wedge HTOs. Methods We reviewed our institutional database to identify all patients having undergone a HTO with subsequent conversion to TKA and identified 188 lateral closing-wedge HTOs and 77 medial opening-wedge HTOs. Mean followup was 88 months (range, 3-264 months) for the lateral closing-wedge HTO cohort and 59 months (range, 3-180 months) for the medial opening-wedge cohort.

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Lateral closing wedge high‐tibial osteotomy is a long‐lasting option for patients under the age of 55 with medial compartment osteoarthritis

Mahmoud,

Garba,

McMeniman

et al. 2024

J. exp. orthop.

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PurposeAssess the survival of the closing wedge high tibial osteotomy (CWHTO) with failure defined as progression to total knee arthroplasty (TKA) and perioperative complications.MethodsPatients undergoing CWHTO in a single centre were included in this study. The patient's demographics, operative data and patient‐reported outcome measures were collected from the medical records. The outcomes assessed were progression to TKA, complications and patient‐reported outcome measures. The Australian joint registry was used to assess which patients progressed to TKA. A binary logistics regression is used to determine if any of the collected factors increase the likelihood of conversion to arthroplasty. Survival analysis is conducted using a Kaplan–Meier survivorship analysis with failure defined as progression to TKA.ResultsThree hundred and fifty‐four (244 males and 110 females) patients were included in the study. The average age of the group was 51 years with an average follow‐up of 18 years. Patients under the age of 55 had a lower rate of progression to TKA. At 15 years, the rate of progression to TKA was 64% and 85% for those under the age of 55 and over 55, respectively. The complication rate was 6% without any peroneal nerve palsies.ConclusionCWHTO is a good surgical option particularly when indicated in patients under the age of 55. Additionally, this technique results in a low overall complication rate with an absence of the often‐feared complication of peroneal nerve palsy.Level of EvidenceLevel III, Retrospective study.

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Total Knee Arthroplasty After Failed High Tibial Osteotomy

Cited by 67 publications

References 20 publications

The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

Total Knee Arthroplasty After High Tibial Osteotomy: No Differences Between Medial and Lateral Osteotomy Approaches

Lateral closing wedge high‐tibial osteotomy is a long‐lasting option for patients under the age of 55 with medial compartment osteoarthritis

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