title: A brief report on managing infected nonunion of a high tibial osteotomy in two stages: a case series involving seven knees.
abstract: The management of nonunion following high tibial osteotomy by total knee replacement (TKR) has been reported previously. We have extended the treatment to embrace cases with an infected high tibial osteotomy by performing an initial debridement with a period of antibiotic treatment followed by TKR. We have reviewed the results of seven knees in six patients with a mean follow-up of 40.5 months (20 to 57) after the staged TKR. At the latest follow-up, all the pseudarthroses had healed and there had been no recurrence of infection. The mean Hospital for Special Surgery knee score improved from 51.2 (35 to 73) to a mean of 91.7 (84 to 98) at final review. Management of nonunion following high tibial osteotomy with a TKR can be extended to infected cases when treated in two stages with a debridement and antibiotic therapy prior to TKR.
authors.affiliation: Department of Orthopaedics, School of Physiotherapy, Dokuz Eylül University, Izmir 35340, Turkey. vasfi.karatosun@deu.edu.tr
authors.forename: V
authors.initials: V
authors.lastname: Karatosun
authors.forename: T
authors.initials: T
authors.lastname: Demir
authors.forename: B
authors.initials: B
authors.lastname: Unver
authors.forename: I
authors.initials: I
authors.lastname: Gunal
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D011859:Radiography; D012086:Reoperation / Q000379:methods; D013530:Surgical Wound Infection / Q000628:therapy*; D013977:Tibia / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents