title: Comparison of quadriceps snip and tibial tubercle osteotomy in revision for infected total knee arthroplasty.
abstract: OBJECTIVE
  Controversies exist regarding the ideal approach in a revision total knee arthroplasty for infection, providing adequate exposure with minimum complications. The purpose of this study was to compare the results of second stage revision total knee arthroplasty (TKA) between tibial tubercle osteotomy (TTO) and quadriceps snip (QS) approaches for infected TKA.
  
  
  METHODS
  The clinical and radiological outcomes of 27 patients of TTO and 21 patients of QS in second stage revision TKA for infected TKA were compared with an average follow up of 51 months. We evaluated the clinical outcomes including HSS score, WOMAC score, flexion contracture, and maximal flexion between two groups. The radiological outcomes in terms of femorotibial alignment, patellar height and complications were also compared.
  
  
  RESULTS
  At the final follow-up, KSS score, HSS score, WOMAC score, flexion contracture, and maximal flexion showed no statistically significant differences between the two groups. The femorotibial alignment and patellar height also showed no differences between the two groups. During the surgery, patellar tendon partial avulsion was more commonly observed in the QS group than in the TTO group (five vs two cases).
  
  
  CONCLUSIONS
  Both tibial tubercle osteotomy and quadriceps snip in revision TKA were considered as good approaches without significant complications. However, cautious exposure of patellar tendon or strong fixation of the osteotomy is needed to minimize the complications.
authors.affiliation: Center for Joint Disease, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
authors.forename: Zhenhui
authors.initials: Z
authors.lastname: Sun
authors.forename: Abhishek
authors.initials: A
authors.lastname: Patil
authors.forename: Eun-Kyoo
authors.initials: EK
authors.lastname: Song
authors.forename: Hyun-Tae
authors.initials: HT
authors.lastname: Kim
authors.forename: Jong-Keun
authors.initials: JK
authors.lastname: Seon
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000601:surgery*; D052097:Quadriceps Muscle / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome