Total Knee Arthroplasty Conversion after Open-wedge High Tibial Osteotomy
Wataru Kusano1, Takatomo Mine1, *, Koichiro Ihara1, Yasuhiro Tominaga1, Hiroyuki Kawamura1, Michio Shinohara1, Ryutaro Kuriyama1
Identifiers and Pagination:Year: 2021
First Page: 53
Last Page: 56
Publisher Id: TOORTHJ-15-53
Article History:Received Date: 2/2/2021
Revision Received Date: 2/6/2021
Acceptance Date: 7/6/2021
Electronic publication date: 15/10/2021
Collection year: 2021
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Open-wedge High Tibial Osteotomy (HTO) is an effective treatment for Osteoarthritis (OA) of the knee; however, postoperative changes due to HTO can make subsequent Total Knee Arthroplasty (TKA) technically difficult and can affect long-term survival.
Medio-lateral stability along with balanced flexion and extension gaps provides a good functional outcome.
A 71-year-old man underwent TKA conversion after open-wedge HTO 12 years earlier; the conversion was performed due to arthritic deterioration in the knee. Medial instability was noted because of poor ligament balancing. The residual medial instability was managed with a knee brace due to the unavailability of the constrained prosthesis. Management of persistent mediolateral instability persisting after soft tissue release and balancing ideally requires varus-valgus constraint.
TKA conversion after open-wedge HTO requires a special technique and careful preparation before surgery.