title: Computer-assisted total knee replacement after medial opening wedge high tibial osteotomy: medium-term results in a series of ninety cases.
abstract: OBJECTIVE
  The aim of this study was to evaluate the medium-term results of total knee replacements (TKRs) after medial opening wedge valgising tibial osteotomy to those of primary TKR (TKR1). The hypothesis being that there would be no difference in results between these groups.
  
  
  METHODS
  Series 1 was made up of 45 TKRs after medial opening wedge high tibial osteotomy (MHTO)-30 men and ten women at an average age of 69 ± seven years (54-82). This was compared to a second series of TKR1s-30 men and ten women at an average age of 69 ± seven years (55-78). The average IKS scores were 91 ± 22.5 points (42-129) and 86 ± 18 points (38-116) in the two groups respectively. The average pre-operative HKA angle was 179 ± 5° (169-193°) in group 1, and 173 ± 7.5° (161-193°) in group 2. Tibial mechanical axes were 90.5 ± 4° (of which 24 knees had a valgus angle) and 85.05 ± 3.5° (79-93°) in the two groups respectively.
  
  
  RESULTS
  All patients were reviewed at an average follow-up of 47 ± 24.5 months for series 1 and 185 ± 8.5 months for series 2. The average IKS score was 184 ± 6 for series 1 (172-200) and 185 ± 8.5 (163-200) for series 2 (p = 0.872). Thirty-seven patients in series 1 and 38 patients in series 2 were either extremely satisfied or satisfied with the intervention. The average post-operative HKA angle was 180.5 ± 2.5° and 181 ± 2° (p = 0.122) and the average tibial mechanical axis was 89 ± 1.5° against 90 ± 1° (p = 0.001). The results of the 24 knees with a valgus tibial mechanical axis were statistically no different.
  
  
  CONCLUSIONS
  TKRs post medial opening wedge high tibial osteotomy have identical results to primary TKRs even in knees with a valgus tibial mechanical axis.
authors.affiliation: Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France. DSaragaglia@chu-grenoble.fr.
authors.forename: Dominique
authors.initials: D
authors.lastname: Saragaglia
authors.affiliation: Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France. JMassfelder@chu-grenoble.fr.
authors.forename: Julie
authors.initials: J
authors.lastname: Massfelder
authors.affiliation: Department of Trauma and Orthopaedics, Wansbeck Hospital, Northumberland, UK. ramsay2000@gmail.com.
authors.forename: Ramsay
authors.initials: R
authors.lastname: Refaie
authors.affiliation: Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France. BRubensduval@chu-grenoble.fr.
authors.forename: Brice
authors.initials: B
authors.lastname: Rubens-Duval
authors.affiliation: Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France. RMader@chu-grenoble.fr.
authors.forename: Roch
authors.initials: R
authors.lastname: Mader
authors.affiliation: Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France. RCRouchy@chu-grenoble.fr.
authors.forename: René Christopher
authors.initials: RC
authors.lastname: Rouchy
authors.affiliation: Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France. RPailhe@chu-grenoble.fr.
authors.forename: Régis
authors.initials: R
authors.lastname: Pailhé
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
keywords: Navigation; Opening wedge high tibial osteotomy; Revision; Total knee replacement