Total knee arthroplasty after high tibial osteotomy: a comparison of opening and closing wedge osteotomy

被引:39
作者
Bastos Filho, Ricardo [1 ,2 ,3 ]
Magnussen, Robert A. [4 ]
Duthon, Victoria [1 ]
Demey, Guillaume [1 ]
Servien, Elvire [1 ]
Granjeiro, Jose Mauro [5 ,6 ]
Neyret, Philippe [1 ]
机构
[1] Hop Croix Rousse, Dept Orthopaed Surg, Ctr Albert Trillat, F-69317 Lyon, France
[2] Minist Educ, CAPES Fdn, Brasilia, DF, Brazil
[3] Univ Fed Fluminense, Postgrad Program, Rio De Janeiro, Brazil
[4] Ohio State Univ, Dept Orthopaed, Sports Hlth & Performance Inst, Columbus, OH 43221 USA
[5] Univ Fed Fluminense, Sch Dent, Rio De Janeiro, Brazil
[6] Natl Inst Metrol,Qual & Technol, Bioengn Div, Brasilia, DF, Brazil
关键词
FOLLOW-UP; VARUS GONARTHROSIS; ARTHRITIS; 10-YEAR;
D O I
10.1007/s00264-012-1765-5
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
High tibial osteotomy (HTO) is frequently used to treat varus osteoarthritis in younger patients with the goal of delaying the need for total knee arthroplasty (TKA). While it has been reported that the results of TKA following HTO are worse than those in patients without prior knee surgery, the influence of osteotomy technique (medial opening-wedge versus lateral closing-wedge) has not been explored. The purpose of this study was to evaluate the influence of HTO technique on the performance and results of TKA. A total of 141 TKA's performed in 118 patients with prior HTO (24 opening wedge and 117 closing wedge) were reviewed at a mean follow-up of two years. Reviewed data included intra-operative factors (tourniquet time, the need for additional exposure, and intra-operative complications), clinical results (International Knee Score (IKS)) and radiographic assessment of limb alignment. The average IKS knee and function scores improved from 54.0 and 60.3 to 87.0 and 79.5 (p < 0.0001). There was no significant difference in IKS scores based on osteotomy technique. There was a trend toward an increased need for tibial tubercle osteotomy in the closing wedge group. There was an increased need for extensive medial release in the opening wedge group and extensive lateral release in the closing wedge group. No differences in tourniquet time, complication rates, or hip-knee-ankle angle were noted between the two groups. Radiographic limb alignment, patient-reported outcomes, and complication rates are equal in patients undergoing TKA after opening and closing wedge HTO.
引用
收藏
页码:427 / 431
页数:5
相关论文
共 24 条
[1]
Backstein David, 2003, J Knee Surg, V16, P203
[2]
Total knee arthroplasty following closed wedge high tibial osteotomy [J].
Bae, Dae Kyung ;
Song, Sang Jun ;
Yoon, Kyoung Ho .
INTERNATIONAL ORTHOPAEDICS, 2010, 34 (02) :283-287
[4]
TKA following high tibial osteotomy versus primary TKA - a matched pair analysis [J].
Efe, Turgay ;
Heyse, Thomas J. ;
Boese, Christoph ;
Timmesfeld, Nina ;
Fuchs-Winkelmann, Susanne ;
Schmitt, Jan ;
Theisen, Christina ;
Schofer, Markus D. .
BMC MUSCULOSKELETAL DISORDERS, 2010, 11
[5]
El Amrani MH, 2010, ORTHOP TRAUMATOL-SUR, V96, P36, DOI [10.1016/j.rcot.2009.11.003, 10.1016/j.otsr.2009.10.009]
[6]
Patellar Height and Posterior Tibial Slope After Open- and Closed-Wedge High Tibial Osteotomy A Radiological Study on 100 Patients [J].
El-Azab, Hosam ;
Glabgly, Parpakorn ;
Paul, Jochen ;
Imhoff, Andreas B. ;
Hinterwimmer, Stefan .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2010, 38 (02) :323-329
[7]
The influence of open and closed high tibial osteotomy on dynamic patellar tracking: a biomechanical study [J].
Gaasbeek, Robert ;
Welsing, Roy ;
Barink, Marco ;
Verdonschot, Nico ;
van Kampen, Albert .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2007, 15 (08) :978-984
[8]
THE TOTAL CONDYLAR KNEE PROSTHESIS IN GONARTHROSIS - A 5 TO 9-YEAR FOLLOW-UP OF THE 1ST 100 CONSECUTIVE REPLACEMENTS [J].
INSALL, JN ;
HOOD, RW ;
FLAWN, LB ;
SULLIVAN, DJ .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1983, 65 (05) :619-628
[9]
HIGH TIBIAL OSTEOTOMY FOR VARUS GONARTHROSIS - A LONG-TERM FOLLOW-UP-STUDY [J].
INSALL, JN ;
JOSEPH, DM ;
MSIKA, C .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1984, 66A (07) :1040-1048
[10]
INSALL JN, 1989, CLIN ORTHOP RELAT R, P13