Total knee arthroplasty after failed dome osteotomy.

A retrospective, clinical and radiographic analysis was done between a study group of 15 patients with 17 total knee arthroplasties done following failed, proximal-tibial dome osteotomies and a control group of 14 patients with 17 primary arthroplasties. The groups were matched according to age of patients, type of prosthesis, primary disease and length of follow-up. The average length of follow-up was 59.4 months (range, 25-146 mo) in the study group and 62.3 months (range, 43-140 mo) in the control group. On the basis of the knee rating scale of the American Knee Society, 94% of the patients had either an excellent or a good result in the study group. There were no significant differences in knee scores, function scores, or range of motion of the knee between the two groups during the follow-up period. Although two overcorrected valgus knees and one severe varus knee necessitated an autogeneic bone graft for tibial defects at the time of implantation of the secondary prosthesis, dome osteotomy does not appear to compromise a subsequent arthroplasty.