title: Single-stage total knee arthroplasty and osteotomy as treatment of secondary osteoarthritis with severe coronal deviation of joint surface due to extra-articular deformity.
abstract: OBJECTIVE
  Severe extra-articular deformities can be treated with single-stage total knee replacement (TKA) and osteotomy. Aim of this study was to examine the patient-reported outcome measures (PROMs) and the complications after single-stage TKA and osteotomy. We hypothesized patients achieve good outcome after single-stage TKA and osteotomy, which is comparable to outcome after primary TKA without deformity.
  
  
  METHODS
  Twenty-one patients with severe extra-articular deformity who underwent single-stage TKA and deformity-correcting osteotomy were reviewed and invited to fill in PROMs including the Oxford Knee Score, the Short Form-12, a Visual Analogue Scale for pain, and questions about satisfaction and quality of life.
  
  
  RESULTS
  The mean follow-up period was 64 months. Ten patients were treated with TKA and supracondylar femoral osteotomy. Although PROMs showed good results (mean quality of life score was 85 out of 100), two patients had a revision of the osteotomy due to non-union. Eleven patients were treated with TKA and high tibial osteotomy. Patients were satisfied with the results (mean quality of life score was 81 out of 100). Two patients developed infection requiring debridement, resulting in one arthrodesis and one gastrocnemius transfer for wound closure.
  
  
  CONCLUSIONS
  In general, patients were satisfied with the postoperative result. Outcome was comparable to patients after primary TKA in the literature. However, serious complications need to be taken into account.
  
  
  METHODS
  III.
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands. wout.veltman@gmail.com.
authors.forename: Ewout S
authors.initials: ES
authors.lastname: Veltman
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands.
authors.forename: Remco J A
authors.initials: RJA
authors.lastname: van Wensen
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands.
authors.forename: Koen C
authors.initials: KC
authors.lastname: Defoort
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands.
authors.forename: Gijs G
authors.initials: GG
authors.lastname: van Hellemondt
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands.
authors.forename: Ate B
authors.initials: AB
authors.lastname: Wymenga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005269:Femur / Q000033:anatomy & histology* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Extra-articular deformity; High tibial osteotomy; Supracondylar femoral osteotomy; Total knee arthroplasty