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J Knee Surg 2017; 30(08): 774-783
DOI: 10.1055/s-0037-1606266
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Total Knee Arthroplasty in Combination with Osteotomies around the Knee

Justus-Martijn Brinkman
1   Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, The Netherlands
2   Knee Reconstruction Centre, Kliniek ViaSana, Mill, The Netherlands
,
Bas Rutten
2   Knee Reconstruction Centre, Kliniek ViaSana, Mill, The Netherlands
,
Ronald van Heerwaarden
1   Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, The Netherlands
› Author Affiliations
Further Information

Publication History

24 June 2017

16 July 2017

Publication Date:
30 August 2017 (online)

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Abstract

Osteotomy around the knee preceding total knee arthroplasty (TKA) has long been perceived as a factor contributing to higher complication rates and increased risk of revision as compared with primary TKA. However, recent systematic reviews and large registry analysis have not been able to confirm this perception. Technical difficulties and slightly higher complication rates can be attributed to older lateral closing wedge tibial osteotomy techniques and are not reported for the more frequently performed tibial medial opening wedge techniques. In the first part of this article, the latest information on this topic will be summarized. The second part of this article deals with osteotomies combined with TKA. Guidelines will be presented for the treatment of osteoarthritic patients with large leg deformities or extra-articular deformities. We aim to describe the latest advances in preoperative planning techniques, including a stepwise decision-making process and a review of the literature about this topic.

Keywords

total knee arthroplasty - extra-articular deformity - supracondylar femoral osteotomy - high tibial osteotomy
 

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