Open AccessTotal Knee Arthroplasty Conversion after Open-wedge High Tibial Osteotomy
Author(s) -
Wataru Kusano,
Takatomo Mine,
Kenji Ihara,
Yoshihiro Tominaga,
Hiroyuki Kawamura,
Michio Shinohara,
Ryutaro Kuriyama
Publication year - 2021
Publication title -
the open orthopaedics journal
Language(s) - English
Resource type - Journals
ISSN - 1874-3250
DOI - 10.2174/1874325002115010053
Subject(s) - high tibial osteotomy , medicine , valgus , osteoarthritis , total knee arthroplasty , osteotomy , brace , surgery , ligament , soft tissue , knee joint , alternative medicine , pathology , engineering , mechanical engineering
Background: Open-wedge High Tibial Osteotomy (HTO) is an effective treatment for Osteoarthritis (OA) of the knee; however, postoperative changes due to HTO can make subsequent Total Knee Arthroplasty (TKA) technically difficult and can affect long-term survival. Case Report: Medio-lateral stability along with balanced flexion and extension gaps provides a good functional outcome. A 71-year-old man underwent TKA conversion after open-wedge HTO 12 years earlier; the conversion was performed due to arthritic deterioration in the knee. Medial instability was noted because of poor ligament balancing. The residual medial instability was managed with a knee brace due to the unavailability of the constrained prosthesis. Management of persistent mediolateral instability persisting after soft tissue release and balancing ideally requires varus-valgus constraint. Conclusion: TKA conversion after open-wedge HTO requires a special technique and careful preparation before surgery.