Total knee arthroplasty after failed high tibial osteotomy long-term follow-up of matched groups.

Forty patients with 51 knee arthroplasties after high tibial osteotomy were compared with a matched group of patients with primary knee arthroplasties. Patients were matched according to length of follow-up, age, sex, prosthetic design, and surgeon. At an average of 12.6 years, the patients were reviewed and assessed clinically using the Hospital for Special Surgery scoring system. Radiologic assessment was also performed. Although the overall Hospital for Special Surgery scores showed no significant difference between the 2 groups, there were more patients in the osteotomy group with a poor result (P = .027), significantly reduced flexion (P = .006), and higher reoperation rate. There were more failures after high tibial osteotomy. Failures tend to occur in the medium to long term, emphasizing the importance of long-term follow-up.