Farfalli Luis A, Farfalli Germán L, Aponte-Tinao Luis A
Institute of Orthopedics and Traumatology CREARTRO--The II Unit of Clinical Traumatology of the National University of Córdoba’s Medical School, Córdoba, Argentina.
Orthopedics. 2012 Apr;35(4):e464-8. doi: 10.3928/01477447-20120327-21.
The outcome of total knee arthroplasty (TKA) after high tibial osteotomy remains uncertain. Compared with primary TKA, the results in some studies are not significantly different. Others report adverse effects on the outcome. The purpose of this study was to determine (1) the middle- and long-term survival of TKA performed after high tibial osteotomy, (2) their clinical and radiographic results, and (3) what complications could be expected in this group of patients.The study group comprised 31 patients (34 knees) undergoing cemented TKA after high tibial osteotomy. Average follow-up was 8 years (range, 6-213 months). Survival of the TKA was estimated using the Kaplan-Meier method. Outcomes were documented using the Hospital for the Special Surgery score. The results showed that the Kaplan-Meier survival rate was 82% at 5 years and 76% at 10 years. Excellent and good clinical results were obtained in 67% of patients. Complications occurred in 12 (35%) knees: stiffness in 4, aseptic loosening in 2, patellofemoral subluxation in 1, instability in 1, inexplicable pain in 1, and deep infection in 3.Great care with technical details is necessary when high tibial osteotomy is indicated because a future conversion to TKA may occur.
胫骨高位截骨术后全膝关节置换术（TKA）的结果仍不确定。与初次TKA相比，一些研究结果无显著差异。其他研究则报告了对结果的不利影响。本研究的目的是确定：（1）胫骨高位截骨术后TKA的中长期生存率；（2）其临床和影像学结果；（3）该组患者可能出现的并发症。研究组包括31例（34膝）胫骨高位截骨术后接受骨水泥型TKA的患者。平均随访时间为8年（范围6 - 213个月）。采用Kaplan-Meier法评估TKA的生存率。使用特种外科医院评分记录结果。结果显示，5年时Kaplan-Meier生存率为82%，10年时为76%。67%的患者获得了优良的临床结果。12膝（35%）出现并发症：4膝僵硬，2膝无菌性松动，1膝髌股关节半脱位，1膝不稳定，1膝不明原因疼痛，3膝深部感染。当需要进行胫骨高位截骨时，必须非常注意技术细节，因为未来可能需要转换为TKA。
