Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 4/2020

Open Access 01-04-2020 | Knee Osteoarthritis | Knee Arthroplasty

A meta-analysis of total knee arthroplasty following high tibial osteotomy versus primary total knee arthroplasty

Authors: Xuedong Sun, Jun Wang, Zheng Su

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2020

Login to get access

Abstract

Background

This study was performed to compare the clinical and radiographic outcomes of total knee arthroplasty (TKA) following high tibial osteotomy (HTO) versus primary TKA.

Methods

Relevant trials were identified via a search of Ovid, PubMed and the Cochrane Central Register of Controlled Trials from inception to 10 January 2019. A meta-analysis was performed to compare postoperative outcomes between revising HTO to TKA (RHTO) and primary TKA (PTKA) with respect to Knee Society Score (KSS), 10-year survival rate, operative time, flexion and extension angle, infection rate and radiographic results.

Results

Sixteen of 340 studies involving 103,552 adult patients (RHTO group, n = 3955; PTKA group, n = 99,597) were eligible for inclusion in the meta-analysis. Compared with primary TKA, revising HTO to TKA required longer operative time and had a higher infection rate (P < 0.05). The PTKA group had better flexion angle than the RHTO group (P < 0.05). There were no significant differences between the two groups in the KSS, extension angle, radiographic results and 10-year survival rate (P > 0.05).

Conclusion

Patients who undergo conversion of HTO to TKA have similar 10-year survival rate, KSS, extension angle and radiographic results as patients who undergo primary TKA. However, conversion of HTO to TKA required longer operative time and had a higher infection rate than performing primary TKA. Moreover, conversion of HTO to TKA is associated with poorer flexion angle than primary TKA.
Literature
1.
Habata T, Uematsu K, Hattori K et al (2006) High tibial osteotomy that does not cause recurrence of varus deformity for medial gonarthrosis. Knee Surg Sports Traumatol Arthrosc 14:962–967PubMed
2.
Lobenhoffer P (2014) Importance of osteotomy around to the knee for medial gonarthritis: indications, technique and results. Orthopade 43:425–431PubMed
3.
Amendola A, Rorabeck CH, Bourne RB et al (1989) Total knee arthroplasty following high tibial osteotomy for osteoarthritis. J Arthroplasty 4(Suppl):S11–S17PubMed
4.
Staeheli JW, Cass JR, Morrey B (1987) Condylar total knee arthroplasty after failed proximal tibial osteotomy. J Bone Joint Surg Am 69(1):28–31PubMed
5.
Katz MM, Hungerford DS, Krackow KA et al (1987) Results of knee arthroplasty after failed proximal tibial osteotomy for osteoarthritis. J Bone Joint Surg Am 69(2):225–233PubMed
6.
Windsor RE, Insall JN, Vince KG (1988) Technical Considerations of total knee arthroplasty after proximal tibial osteotomy. J Bone Joint Surg Am 70(4):547–555PubMed
7.
Tungall JA, Higgins GA, Waddell JP (2010) Complications of closing wedge high tibial osteotomy. Int Orthop 34(2):255–261
8.
Amendola L, Fosco M, Cenni E, Tigani D (2010) Knee joint arthroplasty after tibial osteotomy. Int Orthop 34(2):289–295PubMed
9.
Badawy M, Fenstad AM, Indrekvam K et al (2015) The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy. Acta Orthop 86(6):734–739PubMedPubMedCentral
10.
Bae DK, Song SJ, Park CH et al (2017) Comparison of mid-term results between conversion total knee arthroplasties following closed wedge high tibial osteotomy and primary total knee arthroplasties: a matched pair study including patellar symptom and position. J Orthop Sci 22(3):495–500PubMed
11.
Bergenudd H, Sahlström A, Sanzén L (1997) Total knee arthroplasty after failed proximal tibial valgus osteotomy. J Arthroplast 12(6):635–638
12.
Cross MB, Yi PY, Moric M (2014) Revising an HTO or UKA to TKA: is it more like a primary TKA or a revision TKA? J Arthroplast 29(9 Suppl):229–231
13.
Efe T, Heyse TJ, Boese C et al (2010) TKA following high tibial osteotomy versus primary TKA—a matched pair analysis. BMC Musculoskelet Disord 11:207PubMedPubMedCentral
14.
El-Galaly A, Nielsen PT, Jensen SL et al (2018) Prior high tibial osteotomy does not affect the survival of total knee arthroplasties: results from the Danish Knee Arthroplasty Registry. J Arthroplast 33(7):2131–2135
15.
Haddad FS, Bentley G (2000) Total knee arthroplasty after high tibial osteotomy: a medium-term review. J Arthroplast 15(5):597–603
16.
Haslam P, Armstrong M, Geutjens G et al (2007) Total knee arthroplasty after failed high tibial osteotomy long-term follow-up of matched groups. J Arthroplast 22(2):245–250
17.
Karabatsos B, Mahomed NN, Maistrelli GL (2002) Functional outcome of total knee arthroplasty after high tibial osteotomy. Can J Surg 45(2):116–119PubMedPubMedCentral
18.
Kazakos KJ, Chatzipapas C, Verettas D et al (2008) Mid-term results of total knee arthroplasty after high tibial osteotomy. Arch Orthop Trauma Surg 128(2):167–173PubMed
19.
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(7):1991–1994PubMedPubMedCentral
20.
Niinimäki T, Eskelinen A, Ohtonen P et al (2014) Total knee arthroplasty after high tibial osteotomy: a registry-based case–control study of 1,036 knees. Arch Orthop Trauma Surg 134(1):73–77PubMed
21.
Nizard RS, Cardinne L, Bizot P et al (1998) Total knee replacement after failed tibial osteotomy results of a matched-pair study. J Arthroplast 13(8):847–853
22.
Saragaglia D, Massfelder J, Refaie R et al (2016) Computer-assisted total knee replacement after medial opening wedge high tibial osteotomy: medium-term results in a series of ninety cases. Int Orthop 40(1):35–40PubMed
23.
Toksvig-Larsen S, Magyar G, Onsten I et al (1998) Fixation of the tibial component of total knee arthroplasty after high tibial osteotomy: a matched radiostereometric study. J Bone Joint Surg Br 80(2):295–297PubMed
24.
Miner AL, Lingard EA, Wright EA et al (2003) Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplast 18(3):286–294
25.
Ripanti S, Marin S, Romani G et al (2012) Total knee arthroplasty following high tibial osteotomy. J Bone Joint Surg Br 94:SUPP XXV 195
26.
Farfalli LA, Farfalli GL, Aponte-Tinao LA (2012) Complications in total knee arthroplasty after high tibial osteotomy. Orthopedics 35:e464–e468PubMed
27.
Lee OS, Kwon O, Lee YS (2018) Comparison of the outcome between unilateral and bilateral open wedge high tibial osteotomy in the bilateral varus knees. Arch Orthop Trauma Surg 138(3):307–316PubMed
28.
Bastos Filho R, Magnussen RA, Duthon V (2013) Total knee arthroplasty after high tibial osteotomy: a comparison of opening and closing wedge osteotomy. Int Orthop 37(3):427–431PubMed
29.
30.
Aglietti P, Buzzi R, Vena LM et al (2003) High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg 16(1):21–26PubMed
31.
Coventry MB, Illstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy. A critical long-term study of eighty cases. Bone Joint Surg Am 75(2):196–201
32.
Yasuda K, Majima T, Tsuchida T et al (1992) A 10- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res 282:186–195
33.
Lee OS, Ahn S, Ahn JH et al (2018) Effectiveness of concurrent procedures during high tibial osteotomy for medial compartment osteoarthritis: a systematic review and meta-analysis. Arch Orthop Trauma Surg 138(2):227–236PubMed
34.
Pearse AJ, Hooper GJ, Rothwell AG et al (2012) Osteotomy and unicompartmental knee arthroplasty converted to total knee arthroplasty: data from the New Zealand joint registry. J Arthroplast 27:1827–1831
35.
Parvizi J, Hanssen A, Spangehl MJ (2004) Total knee arthroplasty following proximal tibial osteotomy: risk factors for failure. J Bone Jt Surg Am 86:474–479
36.
Treuter S, Schuh A, Hönle W et al (2012) Long-term results of total knee arthroplasty following high tibial osteotomy according to Wagner. Int Orthop 36:761–764PubMed
37.
Bae DK, Song SJ, Yoon KH (2010) Total knee arthroplasty following closed wedge high tibial osteotomy. Int Orthop 34:283–287PubMed
38.
Nagamine R, Inoue S, Miura H et al (2007) Femoral shaft bowing influences the correction angle for high tibial osteotomy. J Orthop Sci 12:214–218PubMed
39.
Pugely AJ, Martin CT, Gao Y et al (2015) The incidence of and risk factors for 30-day surgical site infections following primary and revision total joint arthroplasty. J Arthroplast 30(9 Suppl):47–50
40.
George J, Mahmood B, Sultan AA et al (2018) How fast should a total knee arthroplasty be performed? An analysis of 140,199 surgeries. J Arthroplast 33(8):2616–2622
41.
Berbari EF, Hanssen AD, Duffy MC et al (1998) Risk factors for prosthetic joint infection: case–control study. Clin Infect Dis 27:1247–1254PubMed
42.
Oiestad BE, Engebretsen L, Storheim K et al (2009) Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 37:1434–1443PubMed
Metadata
Title
A meta-analysis of total knee arthroplasty following high tibial osteotomy versus primary total knee arthroplasty
Authors
Xuedong Sun
Jun Wang
Zheng Su
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 4/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-020-03333-6

Other articles of this Issue 4/2020

Archives of Orthopaedic and Trauma Surgery 4/2020 Go to the issue

Orthopaedic Surgery

The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints

Arthroscopy and Sports Medicine

The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

Hip Arthroplasty

Pre-operative templating in THA. Part II: a CT-based strategy to correct architectural hip deformities

Letter to the Editor

Infrapatellar bursal injection with dextrose and saline are both effective treatments for Osgood–Schlatter disease. Letter to editor for: No superiority of dextrose injections over placebo injections for Osgood–Schlatter disease: a prospective randomized double‑blind study https://doi.org/10.1007/s00402-019-03297-2

Knee Arthroplasty

Patients with anteromedial osteoarthritis achieve the greatest improvement in patient reported outcome after total knee arthroplasty

Trauma Surgery

External iliac artery thrombosis following open reduction of acetabular fracture: a case report and literature review