183 TOTAL KNEE ARTHROPLASTY OF THE KNEE AFTER HIGH TIBIAL OSTEOTOMY

Abstract

If and how closed valgus osteotomy of tibia is possible to influence intra and post operative results of total knee arthroplasty.

Since 1985 to 2002 196 high tibial osteotomies were performed. 57 of them were treated by T.K.A. In 21 of 196 cases diagnostic arthoscopy performed for evaluation of the lesion. All osteotomies were closed wedge. Stabilization of the knee was done with plaster clast and in 50% of cases staples used. The time interval from osteotomy to T.K.A was 2–17 years mean 8 years. Follow-up of T.K.A. was 3–20 years.

Scars, patella Baja, shortens of patellar tendon increased operative time and degree of difficulty. Postoperative results of T.K.A, were evaluated according the WOMAC (pain, stiffness, function) KSS (function) KSRIS (x-ray findings) were the same with those of primary T.K.A.

Postoperative complications:

1. 11 cases decrease in range of knee movment

2. 3 fractures of external tibial condyle

3. 2 mechanical loosening of T.K.A

4. skin necrosis

5. rupture of extension complex.

Intaoperative difficulties in high valgus tibial osteotomy and afterrwords in T.K.A. were increased although postoperative results were the same. This is the reason that surgical experience is the target point of the result