Abstract
Introduction: Previous reports have described the potentially compromising effect of a high tibial osteotomy (HTO) on the results of a subsequent total knee arthroplasty (TKA). Although the reasons are not clear, some authors reported of problems in soft tissue balancing in TKA following a previous HTO.
Method: In a prospective study 22 patients with an average interval of 5.8 years after closed wedge HTO, were operated for TKA. All surgeries were performed with the BrainLAB CT-free navigation system and measurements of the extension and flexion gap were assessed. The intraoperative data were compared to a control group of 100 consecutive computer assisted TKA without previous HTO.
Results: In the study group a highly significant shift towards a medial opening of the flexion gap between the posterior condylar line and the tibial resection (study group 0.4° +/− 4.7° medial opening vs. control group 3.4° +/− 3.3° lateral opening, p< 0.001) was observed. 45% in the study group showed a medial opening of the flexion gap compared to 11% in the control group.
Conclusion: Surgeons should be aware of difficulties in soft-tissue balance in TKA following HTO, especially for the flexion gap configuration and the axial femoral component orientation. The computer assisted technique is helpful to identify soft tissue imbalance.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
