Potential complications of total knee replacement following tibial osteotomy.

Ligament balancing in total knee replacement allows the correction of virtually any intra-articular deformity and the use of a semi-constrained knee. The capacity for overcorrection to balance extra-articular deformities is, however, quite limited. The authors found this to be true in a case requiring tibial osteotomy after total knee replacement. Eventually, the patient required a long-stem hinge prosthesis. After this case, the authors have preferred to correct extra-articular bony deformities of more than 15 degrees prior to total knee replacement.