Total knee arthroplasty after high tibial osteotomy

A total of 50 consecutive knee arthroplasties in 42 patients who had undergone previous high tibial osteotomies have been reviewed with a minimum follow-up of 5 years and compared with 50 age-matched and sex-matched primary total knee arthroplasties. There were no significant preoperative differences between the 2 groups. Surgery in the osteotomy group took on average 23 minutes longer (P <.02), and there was a decrease of 8° flexion postoperatively but without an associated difference in knee scores. Patellar subluxation was also seen more frequently (P <.05). There was no difference in the revision rate at an average follow-up of >6.2 years. Although there are significant technical difficulties and subtle clinical differences, the overall outcome remains good to excellent in most cases.