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Archives of Orthopaedic and Trauma Surgery

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01-09-2014 | Knee Revision Surgery

Tibial tubercle osteotomy in septic revision total knee arthroplasty

Authors: Josep M. Segur, Felix Vilchez-Cavazos, Juan Carlos Martinez-Pastor, Francisco Macule, Santiago Suso, Carlos Acosta-Olivo

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2014

Abstract

Purpose

The incidence of revision knee arthroplasty for infection is increasing and the required surgical approach for the revision is a challenge for surgeons. Extensile approaches are frequently used when it is impossible to evert the extensor mechanism. The aim of this paper is to report our experience with tibial tubercle osteotomy (TTO) and the functional results in patients who underwent a two-stage revision due to prosthesis infection.

Methods

Twenty-six patients underwent a TTO as a surgical approach in the second stage of revision for infection. The patients were clinically assessed by means of functional scales (the Knee Society Score and WOMAC) and X-rays.

Results

The TTO healed without complications in 22 patients (84.6 %) and the average length of follow-up was 3.4 years. Non-union was observed in two patients. One patient presented an extension lag of 5°. A total of 23 patients (88.4 %) were free from infection. Twenty-five patients (96.1 %) had better scores on the Knee Society Score and WOMAC after the procedure.

Conclusions

In patients undergoing the second stage of revision total knee arthroplasty for infection, the TTO approach provides a large operating field. This enables surgeons to withdraw spacers and position new implants without damaging the extensor mechanism of the knee or altering the postoperative rehabilitation process. The complications that have been reported as a result of this procedure could be reduced by performing a meticulous surgical technique.

Level of evidence

Retrospective case series, Level IV.

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Title: Tibial tubercle osteotomy in septic revision total knee arthroplasty
Authors: Josep M. Segur
Felix Vilchez-Cavazos
Juan Carlos Martinez-Pastor
Francisco Macule
Santiago Suso
Carlos Acosta-Olivo
Publication date: 01-09-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 9/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-014-2064-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Tibial tubercle osteotomy in septic revision total knee arthroplasty

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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