title: Tibial tubercle osteotomy in septic revision total knee arthroplasty.
abstract: OBJECTIVE
  The incidence of revision knee arthroplasty for infection is increasing and the required surgical approach for the revision is a challenge for surgeons. Extensile approaches are frequently used when it is impossible to evert the extensor mechanism. The aim of this paper is to report our experience with tibial tubercle osteotomy (TTO) and the functional results in patients who underwent a two-stage revision due to prosthesis infection.
  
  
  METHODS
  Twenty-six patients underwent a TTO as a surgical approach in the second stage of revision for infection. The patients were clinically assessed by means of functional scales (the Knee Society Score and WOMAC) and X-rays.
  
  
  RESULTS
  The TTO healed without complications in 22 patients (84.6%) and the average length of follow-up was 3.4 years. Non-union was observed in two patients. One patient presented an extension lag of 5°. A total of 23 patients (88.4%) were free from infection. Twenty-five patients (96.1%) had better scores on the Knee Society Score and WOMAC after the procedure.
  
  
  CONCLUSIONS
  In patients undergoing the second stage of revision total knee arthroplasty for infection, the TTO approach provides a large operating field. This enables surgeons to withdraw spacers and position new implants without damaging the extensor mechanism of the knee or altering the postoperative rehabilitation process. The complications that have been reported as a result of this procedure could be reduced by performing a meticulous surgical technique.
  
  
  METHODS
  Retrospective case series, Level IV.
authors: Service of Orthopaedic Surgery, Knee Unit, Hospital Clinic, Barcelona, Spain.
authors: Josep M
authors: JM
authors: Segur
authors: Felix
authors: F
authors: Vilchez-Cavazos
authors: Juan Carlos
authors: JC
authors: Martinez-Pastor
authors: Francisco
authors: F
authors: Macule
authors: Santiago
authors: S
authors: Suso
authors: Carlos
authors: C
authors: Acosta-Olivo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome