Total knee replacement after failed tibial osteotomy: results of a matched-pair study.
Sixty-three total knee replacements were performed after a failed tibial osteotomy. The goal of this study was to compare the perioperative problems and the outcome of this group of patients (study group) to a group of patients with primary arthroplasties matched for age, gender, length of follow-up, weight, and preoperative Charnley class. Operative problems were more frequently encountered in the study group, with 7 tibial tubercle elevations and 15 lateral retinaculum releases needed, whereas lateral retinaculum release was necessary for only 1 knee in the control group. Outcome was assessed using both the International Knee Society (IKS) scoring system and Hospital for Special Surgery (HSS) knee score. The follow-up period averaged 4.6 years. The IKS score of the control group was significantly higher, averaging 80.9 +/- 13.8, whereas it was 74.4 +/- 14.8 for the study group (P = .0001). Among the parameters included in the knee score, only pain was significantly different with the control group (P = .03). The IKS function score and the HSS score were not statistically different. Conversion of a failed tibial osteotomy is a technically demanding procedure. Careful preoperative planning is needed. Results, especially on pain, appeared to be inferior to those for primary arthroplasties.
Nizard
R S
RS
Hôpital Lariboisière, Paris, France.
Cardinne
L
L
Bizot
P
P
Witvoet
J
J
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D007720:Knee Prosthesis; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D013977:Tibia / Q000601:surgery*; D013997:Time Factors; D017211:Treatment Failure