title: Total knee arthroplasty after failed distal femoral varus osteotomy using selectively stemmed posterior stabilized components.
abstract: The purpose of this study was to evaluate the outcomes of patients treated with total knee arthroplasty (TKA) for progression of arthritis after distal femoral varus osteotomy. Twenty-two consecutive distal femoral varus osteotomies converted to TKA were reviewed at a mean follow-up of 5 years (range, 2-14 years). Stemmed femoral or tibial components were used in 5 knees with poor bone quality, while the remaining 17 knees were treated with unstemmed components. The mean Knee Society knee and function scores in surviving knees were 91 points (range, 67-100 points) and 64 points (range, 50-70 points) respectively at final follow-up. Two patients underwent revision arthroplasty for polyethylene wear and component loosening at 8 and 11 years after the index arthroplasty, respectively. Standard components provide satisfactory stability in TKA after distal femoral varus osteotomy after appropriate ligamentous balancing, without the need for stemmed or highly constrained components in the majority of patients.
authors.affiliation: Division of Orthopaedic Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Yona
authors.initials: Y
authors.lastname: Kosashvili
authors.forename: Allan E
authors.initials: AE
authors.lastname: Gross
authors.forename: Michael G
authors.initials: MG
authors.lastname: Zywiel
authors.forename: Oleg
authors.initials: O
authors.lastname: Safir
authors.forename: Dror
authors.initials: D
authors.lastname: Lakstein
authors.forename: David
authors.initials: D
authors.lastname: Backstein
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D017211:Treatment Failure; D016896:Treatment Outcome