Outcome Evaluation of Total Knee Arthroplasty among Patients With and Without Previous High Tibial Osteotomy

There is still controversy as to whether or not high tibial osteotomy can have any deleterious effects on the outcome of total knee replacement after high tibial osteotomy. The goal of this study was to compare the outcome of this group of patients (study group) to a group of patients with primary total knee replacement. This study was a clinical trial and 38 patients with 41 knee arthroplasties after high tibial osteotomy were compared with a matched group (in regard to duration of follow-up, age, sex, etiology) of patients with primary knee arthroplasty. The follow-up period averaged 4 years. Outcome was assessed using Hospital for Special Surgery (HSS) knee score. Radiologic assessment was also performed. In this study, Chi2, Mann-Whitney U-test, and Independent samples t-test were used to carry out the statistical analyses. SPSS V.16 was also used for data analysis. Surgery in the study group took on average 10 minutes longer (p=0.01), and operative problems were more frequently encountered in the study group. Although the overall Hospital for Special Surgery scores (HSS) showed no significant difference between the two groups, there were more patients in the study group with a poor result (without significant difference). Insall-Salvati ratio in study group was less than control group significantly both before and after surgery (p=0.03, p=0.01). Although there are significant technical difficulties, the overall clinical outcome remains good to excellent in both groups without significant difference.