title: Utility of tibial tubercle osteotomy in the setting of periprosthetic infection after total knee arthroplasty.
abstract: OBJECTIVE
  This study reports radiographic and clinical treatment outcomes of tibial tubercle osteotomy (TTO) used for two-stage revision total knee arthroplasty (TKA) in the setting of periprosthetic infection.
  
  
  METHODS
  Thirty-six patients with 51 TTOs used for infected TKA were retrospectively analysed from 2000 to 2010. In 15 of 36 patients, TTO was used in a sequential manner during both first and second stage procedures. The mean follow-up period was 57 months (range seven-126 months).
  
  
  RESULTS
  The mean pre-operative range of knee motion was 40° (range 10-90°), and at latest follow-up it was 92° (range 50-140°). The Knee Society knee scores and function scores were 47 and 9 pre-operatively and 82 and 72 at latest follow-up, respectively. Bony union was achieved in all cases except one nonunion of an avulsion fragment of the osteotomy segment without functional deterioration.
  
  
  CONCLUSIONS
  TTO can be a useful extensile surgical approach for treatment of infected TKA with satisfactory clinical and radiographic outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, The Harris Orthopedic Laboratory, Harvard Medical School, Boston, MA, USA.
authors.forename: Ho-Rim
authors.initials: HR
authors.lastname: Choi
authors.forename: Dennis
authors.initials: D
authors.lastname: Burke
authors.forename: Henrik
authors.initials: H
authors.lastname: Malchau
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery; D007720:Knee Prosthesis / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome