Hee-June Kim1, Young-Gun Kim1, Seung-Gi Min1, Hee-Soo Kyung2. 1. Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea. 2. Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea. Electronic address: hskyung@knu.ac.kr.
Abstract
BACKGROUND: The changes in the anatomy that occur due to a high tibial osteotomy (HTO), including the ligament release, can affect the clinical results after a subsequent total knee arthroplasty (TKA). We present three cases in which patients underwent conversion to a TKA after an open-wedge HTO. Of particular interest is the medial instability that was noted during the TKA procedures. METHODS: Three patients underwent conversion to a TKA after an open-wedge HTO. RESULTS: One case was converted to a TKA using a conventional posterior-stabilized type implant, and the other case was converted to a TKA using varus-valgus constraint-type implants due to the medial instability. The final case was converted to TKA using a conventional posterior-stabilized type implant, but a revision TKA using constrained-type implant was performed due to neglected medial instability. CONCLUSION: Conversion to a TKA after open-wedge HTO requires careful preparation and a constrained-type implant should be prepared to address the medial structure release. Furthermore, medial structures should be repaired during open-wedge HTO, in case the patient requires a future TKA conversion. Copyright Â
BACKGROUND: The changes in the anatomy that occur due to a high tibial osteotomy (HTO), including the ligament release, can affect the clinical results after a subsequent total knee arthroplasty (TKA). We present three cases in which patients underwent conversion to a TKA after an open-wedge HTO. Of particular interest is the medial instability that was noted during the TKA procedures. METHODS: Three patients underwent conversion to a TKA after an open-wedge HTO. RESULTS: One case was converted to a TKA using a conventional posterior-stabilized type implant, and the other case was converted to a TKA using varus-valgus constraint-type implants due to the medial instability. The final case was converted to TKA using a conventional posterior-stabilized type implant, but a revision TKA using constrained-type implant was performed due to neglected medial instability. CONCLUSION: Conversion to a TKA after open-wedge HTO requires careful preparation and a constrained-type implant should be prepared to address the medial structure release. Furthermore, medial structures should be repaired during open-wedge HTO, in case the patient requires a future TKA conversion. Copyright Â