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Total knee arthroplasty after failed high tibial osteotomy: a systematic review of open versus closed wedge osteotomy

Abstract

Purpose

Medial opening wedge high tibial osteotomy (HTO) has become increasingly popular as an alternative to lateral closing wedge osteotomy for the treatment of medial compartment knee osteoarthritis with varus deformity. The present systematic review was conducted to provide an objective analysis of total knee arthroplasty (TKA) outcomes following previous knee osteotomy (medial opening wedge vs. lateral closing wedge).

Methods

A literature search of online databases (MEDLINE, EMBASE, Cochrane Library database) was made, in addition to manual search of major orthopaedic journals. The methodological quality of each of the studies was assessed on the Newcastle–Ottawa Scale and Effective Practice and Organization of Care. A total of ten studies were included in the review. There were eight studies with Level IV and two studies with Level III evidence.

Results

Eight studies reported clinical and radiologic scores. Comparative studies between TKA following medial opening and lateral closing wedge HTO did not demonstrate statistically significant clinical and radiologic differences. The revision rates were similar. However, more technical issues during TKA surgery after lateral closing wedge HTO were mentioned than the medial open wedge group. The quadriceps snip, tibial tubercle osteotomy, and lateral soft tissue release were more frequently needed in the lateral closing wedge HTO group. In addition, because of loss of proximal tibia bone geometry in the lateral closing wedge HTO group, concerns such as tibia stem impingement in the lateral tibial cortex was noted.

Conclusion

The present systematic review suggests that TKA after medial opening and lateral closing wedge HTO showed similar performance. Clinical and radiologic outcome including revision rates did not statistically differ from included studies. However, there are more surgical technical concerns in TKA conversion from lateral closing wedge HTO than from the medial opening wedge HTO group.

Level of evidence

IV.

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References

  1. 1.

    Akasaki Y, Matsuda S, Miura H, Okazaki K, Moro-oka TA, Mizu-uchi H, Iwamoto Y (2009) Total knee arthroplasty following failed high tibial osteotomy: mid-term comparison of posterior cruciate-retaining versus posterior stabilized prosthesis. Knee Surg Sports Traumatol Arthrosc 17:795–799

  2. 2.

    Bae DK, Song SJ, Yoon KH (2010) Total knee arthroplasty following closed wedge high tibial osteotomy. Int Orthop 34:283–287

  3. 3.

    Bastos Filho R, Magnussen RA, Duthon V, Demey G, Servien E, Granjeiro JM, Neyret P (2013) Total knee arthroplasty after high tibial osteotomy: a comparison of opening and closing wedge osteotomy. Int Orthop 37:427–431

  4. 4.

    Bergenudd H, Sahlstrom A, Sanzen L (1997) Total knee arthroplasty after failed proximal tibial valgus osteotomy. J Arthroplasty 12:635–638

  5. 5.

    Cerciello S, Vasso M, Maffulli N, Neyret P, Corona K, Panni AS (2014) Total knee arthroplasty after high tibial osteotomy. Orthopedics 37:191–198

  6. 6.

    Chen JY, Lo NN, Chong HC, Pang HN, Tay DK, Chin PL, Chia SL, Yeo SJ (2014) Cruciate retaining versus posterior stabilized total knee arthroplasty after previous high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3259-z

  7. 7.

    Coventry MB (1965) Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am 47:984–990

  8. 8.

    Erak S, Naudie D, MacDonald SJ, McCalden RW, Rorabeck CH, Bourne RB (2011) Total knee arthroplasty following medial opening wedge tibial osteotomy: technical issues early clinical radiological results. Knee 18:499–504

  9. 9.

    Farfalli LA, Farfalli GL, Aponte-Tinao LA (2012) Complications in total knee arthroplasty after high tibial osteotomy. Orthopedics 35:e464–e468

  10. 10.

    Gupta H, Dahiya V, Vasdev A, Rajgopal A (2013) Outcomes of total knee arthroplasty following high tibial osteotomy. Indian J Orthop 47:469–473

  11. 11.

    Haddad FS, Bentley G (2000) Total knee arthroplasty after high tibial osteotomy: a medium-term review. J Arthroplasty 15:597–603

  12. 12.

    Hooper G, Leslie H, Burn J, Schouten R, Beci I (2005) Oblique upper tibial opening wedge osteotomy for genu varum. Oper Orthop Traumatol 17:662–673

  13. 13.

    Insall JN, Joseph DM, Msika C (1984) High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 66:1040–1048

  14. 14.

    Kawano T, Miura H, Nagamine R, Urabe K, Matsuda S, Mawatari T, Moro-Oka T, Iwamoto Y (2003) Alignment in total knee arthroplasty following failed high tibial osteotomy. J Knee Surg 16:168–172

  15. 15.

    Kazakos KJ, Chatzipapas C, Verettas D, Galanis V, Xarchas KC, Psillakis I (2008) Mid-term results of total knee arthroplasty after high tibial osteotomy. Arch Orthop Trauma Surg 128:167–173

  16. 16.

    Mason JB, Fehring TK, Estok R, Banel D, Fahrbach K (2007) Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty 22:1097–1106

  17. 17.

    McNamara I, Birmingham TB, Fowler PJ, Giffin JR (2013) High tibial osteotomy: evolution of research and clinical applications–a Canadian experience. Knee Surg Sports Traumatol Arthrosc 21:23–31

  18. 18.

    Meding JB, Wing JT, Ritter MA (2011) Does high tibial osteotomy affect the success or survival of a total knee replacement? Clin Orthop Relat Res 469:1991–1994

  19. 19.

    Nizard RS, Cardinne L, Bizot P, Witvoet J (1998) Total knee replacement after failed tibial osteotomy: results of a matched-pair study. J Arthroplasty 13:847–853

  20. 20.

    Orban H, Mares E, Dragusanu M, Stan G (2011) Total knee arthroplasty following high tibial osteotomy—a radiological evaluation. Maedica (Buchar) 6:23–27

  21. 21.

    Parvizi J, Hanssen AD, Spangehl MJ (2004) Total knee arthroplasty following proximal tibial osteotomy: risk factors for failure. J Bone Joint Surg Am 86-A:474–479

  22. 22.

    Preston S, Howard J, Naudie D, Somerville L, McAuley J (2014) Total knee arthroplasty after high tibial osteotomy: no differences between medial and lateral osteotomy approaches. Clin Orthop Relat Res 472:105–110

  23. 23.

    Ramappa M, Anand S, Jennings A (2013) Total knee replacement following high tibial osteotomy versus total knee replacement without high tibial osteotomy: a systematic review and meta analysis. Arch Orthop Trauma Surg 133:1587–1593

  24. 24.

    Treuter S, Schuh A, Honle W, Ismail MS, Chirag TN, Fujak A (2012) Long-term results of total knee arthroplasty following high tibial osteotomy according to Wagner. Int Orthop 36:761–764

  25. 25.

    van Raaij TM, Reijman M, Furlan AD, Verhaar JA (2009) Total knee arthroplasty after high tibial osteotomy. A systematic review. BMC Musculoskelet Disord 10:88

  26. 26.

    Walther M, Konig A, Kirschner S, Gohlke F (2000) Results of posterior cruciate-retaining unconstrained total knee arthroplasty after proximal tibial osteotomy for osteoarthritis. A prospective cohort study. Arch Orthop Trauma Surg 120:166–170

  27. 27.

    Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M et al (1999) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Ottawa, ON, Ottawa Health Research Institute

  28. 28.

    Windsor RE, Insall JN, Vince KG (1988) Technical considerations of total knee arthroplasty after proximal tibial osteotomy. J Bone Joint Surg Am 70:547–555

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Author information

Correspondence to Kyung Wook Nha.

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Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

Additional information

Jae Hwi Han and Jae-Hyuk Yang contributed equally to this work as co-first authors.

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Han, J.H., Yang, J., Bhandare, N.N. et al. Total knee arthroplasty after failed high tibial osteotomy: a systematic review of open versus closed wedge osteotomy. Knee Surg Sports Traumatol Arthrosc 24, 2567–2577 (2016). https://doi.org/10.1007/s00167-015-3807-1

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Keywords

  • Total knee arthroplasty
  • High tibial osteotomy
  • Closed
  • Open
  • Systematic review