Total knee arthroplasty conversion after open-wedge high tibial osteotomy: A report of three cases.
BACKGROUND
The changes in the anatomy that occur due to a high tibial osteotomy (HTO), including the ligament release, can affect the clinical results after a subsequent total knee arthroplasty (TKA). We present three cases in which patients underwent conversion to a TKA after an open-wedge HTO. Of particular interest is the medial instability that was noted during the TKA procedures.


METHODS
Three patients underwent conversion to a TKA after an open-wedge HTO.


RESULTS
One case was converted to a TKA using a conventional posterior-stabilized type implant, and the other case was converted to a TKA using varus-valgus constraint-type implants due to the medial instability. The final case was converted to TKA using a conventional posterior-stabilized type implant, but a revision TKA using constrained-type implant was performed due to neglected medial instability.


CONCLUSIONS
Conversion to a TKA after open-wedge HTO requires careful preparation and a constrained-type implant should be prepared to address the medial structure release. Furthermore, medial structures should be repaired during open-wedge HTO, in case the patient requires a future TKA conversion.
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
Hee-June
HJ
Kim
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
Young-Gun
YG
Kim
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
Seung-Gi
SG
Min
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea. Electronic address: hskyung@knu.ac.kr.
Hee-Soo
HS
Kyung
D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy; D013977:Tibia / Q000601:surgery*
Medial instability; Open-wedge high tibial osteotomy; TKA conversion