title: Bilateral non-union of high tibial osteotomies treated by total knee arthroplasty: a case report.
abstract: Non-union following high tibial osteotomy (HTO) is very uncommon. We present a case of bilateral non-union of HTOs with end-stage knee arthritis treated with staged, bilateral, posterior stabilized knee replacements. A 77-year-old female presented to our clinic with complaints of debilitating knee pain. She used a frame to get about in her home, she was unable to get up stairs, and she rarely went outside. Simple radiographs revealed bilateral non-unions of her osteotomies, subluxation of the tibial plateauxs and severe knee osteoarthritis. At the time of surgery, the non-unions were found to be fibrous stable. We took a minimal tibial plateaux resection and used long stem tibial stems with offset couplers to bypass the non-unions. At minimum 1 year follow-up, she was walking pain free with full knee range of motion. We found that primary total knee replacement (TKR) using tibial stems and without treating the tibial non-union gave satisfactory results.
authors.affiliation: Division of Orthopedic Surgery, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada M5T 2S8. Rajiv.gandhi@uhn.on.ca
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gandhi
authors.forename: Abdullah
authors.initials: A
authors.lastname: Alomran
authors.forename: Nizar
authors.initials: N
authors.lastname: Mahomed
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D020370:Osteoarthritis, Knee / Q000601:surgery; D010027:Osteotomy / Q000009:adverse effects*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D014945:Wound Healing