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Philip M. Faris - One of the best experts on this subject based on the ideXlab platform.
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Total knee arthroplasty after High Tibial Osteotomy.
Clinical orthopaedics and related research, 2000Co-Authors: John B. Meding, Merrill A. Ritter, Philip M. FarisAbstract:Between 1980 and 1995, 95 consecutive total knee replacements were performed at an average of 10 years 4 months after High Tibial Osteotomy. The average age of the 82 patients was 66 years, with a preoperative diagnosis of osteoarthritis in 94 knees. One patient died 6 months after surgery. The followup of the remaining 81 patients (94 knees) averaged 8.6 years (range, 2-17 years). Knee Society knee score at final followup improved to an average of 87.6 points from a preoperative average of 38.1 points. No pain was present in 86.2% of knees, and 12.8% of knees had only mild or occasional pain. Tibial radiolucencies were identified in 12 (12.8%) knees at final followup, and in only four knees were radiolucent lines found about the lateral zones. Only one Tibial component required revision 3 years after surgery. Although no preoperative factor was identified that predisposed to an inferior knee score, function score, or pain score, the severity of the preoperative flexion contracture and the number of previous surgeries did relate to diminished postoperative motion. However, an increased number of patellar radiolucencies were seen in the knees in which the lateral joint line was raised (referenced from the fibular head) a greater degree. The clinical results of total knee replacement after High Tibial Osteotomy appeared similar to those of primary total knee replacement. The previous High Tibial Osteotomy had no adverse effect on the eventual results of a cemented posterior cruciate retaining total knee replacement.
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Total knee arthroplasty after High Tibial Osteotomy. A comparison study in patients who had bilateral total knee replacement.
The Journal of bone and joint surgery. American volume, 2000Co-Authors: John B. Meding, Merrill A. Ritter, E M Keating, Philip M. FarisAbstract:Background The outcome of total knee replacement after High Tibial Osteotomy remains uncertain. We hypothesized that the results of total knee replacement with or without a previous High Tibial Osteotomy are similar. Methods The results of a consecutive series of thirty-nine bilateral total knee arthroplasties performed with cement at an average of 8.7 years after unilateral High Tibial Osteotomy were reviewed. There were twenty-seven men and twelve women. Preoperatively, the knee scores according to the system of the Knee Society were similar for all of the knees; however, valgus alignment and patella infera were more common in the knees with a previous High Tibial Osteotomy. Bilateral total knee replacement was staged in seven patients and was simultaneous in thirty-two patients. The results of the total knee arthroplasties were retrospectively reviewed with respect to the knee and function scores according to the system of the Knee Society, the radiographic findings, and the complications. Results Intraoperatively, no notable differences were identified in the number of medial, lateral, or lateral patellar releases required. However, less lateral Tibial bone was resected in the group with a previous High Tibial Osteotomy (average, 3.3 millimeters) than in the group without a High Tibial Osteotomy (average, 7.5 millimeters). The average duration of follow-up was 7.5 years (range, three to sixteen years) in the group with a previous High Tibial Osteotomy and 6.8 years (range, two to ten years) in the group without a High Tibial Osteotomy. At the time of the final follow-up, the knee and function scores were similar for the two groups (89.0 and 81.0 points, respectively, for the group with a previous High Tibial Osteotomy, and 89.6 and 83.9 points, respectively, for the group without a High Tibial Osteotomy). Although more knees were free of pain in the group without a previous High Tibial Osteotomy (thirty-six) than in the group with a previous Osteotomy (thirty-three), this difference was not found to be significant with the numbers available (p = 0.4810). Knee alignment and stability, femoral and Tibial component alignment, and range of motion also were similar in both groups postoperatively. One allpolyethylene Tibial component was revised in the High Tibial Osteotomy group. Two knees in each group required manipulation. There were no deep infections. Conclusions While patients with a previous High Tibial Osteotomy may have important differences preoperatively, including valgus alignment, patella infera, and decreased bone stock in the proximal part of the tibia, the present study suggests that the clinical and radiographic results of primary total knee arthroplasty in knees with and without a previous High Tibial Osteotomy are not substantially different. In our relatively small group of patients, the previous High Tibial Osteotomy had no adverse effect on the outcome of the subsequent total knee replacement.
John B. Meding - One of the best experts on this subject based on the ideXlab platform.
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Total knee arthroplasty after High Tibial Osteotomy.
Clinical orthopaedics and related research, 2000Co-Authors: John B. Meding, Merrill A. Ritter, Philip M. FarisAbstract:Between 1980 and 1995, 95 consecutive total knee replacements were performed at an average of 10 years 4 months after High Tibial Osteotomy. The average age of the 82 patients was 66 years, with a preoperative diagnosis of osteoarthritis in 94 knees. One patient died 6 months after surgery. The followup of the remaining 81 patients (94 knees) averaged 8.6 years (range, 2-17 years). Knee Society knee score at final followup improved to an average of 87.6 points from a preoperative average of 38.1 points. No pain was present in 86.2% of knees, and 12.8% of knees had only mild or occasional pain. Tibial radiolucencies were identified in 12 (12.8%) knees at final followup, and in only four knees were radiolucent lines found about the lateral zones. Only one Tibial component required revision 3 years after surgery. Although no preoperative factor was identified that predisposed to an inferior knee score, function score, or pain score, the severity of the preoperative flexion contracture and the number of previous surgeries did relate to diminished postoperative motion. However, an increased number of patellar radiolucencies were seen in the knees in which the lateral joint line was raised (referenced from the fibular head) a greater degree. The clinical results of total knee replacement after High Tibial Osteotomy appeared similar to those of primary total knee replacement. The previous High Tibial Osteotomy had no adverse effect on the eventual results of a cemented posterior cruciate retaining total knee replacement.
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Total knee arthroplasty after High Tibial Osteotomy. A comparison study in patients who had bilateral total knee replacement.
The Journal of bone and joint surgery. American volume, 2000Co-Authors: John B. Meding, Merrill A. Ritter, E M Keating, Philip M. FarisAbstract:Background The outcome of total knee replacement after High Tibial Osteotomy remains uncertain. We hypothesized that the results of total knee replacement with or without a previous High Tibial Osteotomy are similar. Methods The results of a consecutive series of thirty-nine bilateral total knee arthroplasties performed with cement at an average of 8.7 years after unilateral High Tibial Osteotomy were reviewed. There were twenty-seven men and twelve women. Preoperatively, the knee scores according to the system of the Knee Society were similar for all of the knees; however, valgus alignment and patella infera were more common in the knees with a previous High Tibial Osteotomy. Bilateral total knee replacement was staged in seven patients and was simultaneous in thirty-two patients. The results of the total knee arthroplasties were retrospectively reviewed with respect to the knee and function scores according to the system of the Knee Society, the radiographic findings, and the complications. Results Intraoperatively, no notable differences were identified in the number of medial, lateral, or lateral patellar releases required. However, less lateral Tibial bone was resected in the group with a previous High Tibial Osteotomy (average, 3.3 millimeters) than in the group without a High Tibial Osteotomy (average, 7.5 millimeters). The average duration of follow-up was 7.5 years (range, three to sixteen years) in the group with a previous High Tibial Osteotomy and 6.8 years (range, two to ten years) in the group without a High Tibial Osteotomy. At the time of the final follow-up, the knee and function scores were similar for the two groups (89.0 and 81.0 points, respectively, for the group with a previous High Tibial Osteotomy, and 89.6 and 83.9 points, respectively, for the group without a High Tibial Osteotomy). Although more knees were free of pain in the group without a previous High Tibial Osteotomy (thirty-six) than in the group with a previous Osteotomy (thirty-three), this difference was not found to be significant with the numbers available (p = 0.4810). Knee alignment and stability, femoral and Tibial component alignment, and range of motion also were similar in both groups postoperatively. One allpolyethylene Tibial component was revised in the High Tibial Osteotomy group. Two knees in each group required manipulation. There were no deep infections. Conclusions While patients with a previous High Tibial Osteotomy may have important differences preoperatively, including valgus alignment, patella infera, and decreased bone stock in the proximal part of the tibia, the present study suggests that the clinical and radiographic results of primary total knee arthroplasty in knees with and without a previous High Tibial Osteotomy are not substantially different. In our relatively small group of patients, the previous High Tibial Osteotomy had no adverse effect on the outcome of the subsequent total knee replacement.
Paul Zalzal - One of the best experts on this subject based on the ideXlab platform.
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Navigation versus conventional High Tibial Osteotomy: systematic review
SpringerPlus, 2015Co-Authors: Khaled Hasan, Qusai Abdel Rahman, Paul ZalzalAbstract:One major use for High Tibial Osteotomy aims at improving alignment in the symptomatic, varus malaligned, medial compartment osteoarthritic knee. The importance of achieving correct alignment is obvious upon considering the increased potential for significant complications with over- or undercorrection in any plane. The aim of this systematic review was to compare navigation and conventional High Tibial Osteotomy. This systematic review searched the MEDLINE and EMBASE databases to compare the short-term clinical and radiological outcomes between patients undergoing either conventional or navigated High Tibial Osteotomy. We retrieved 71 articles, which ultimately resulted in 14 eligible studies for inclusion. Though heterogeneity prevented statistical analysis, only one study failed to suggest superiority of navigation over conventional techniques. Navigated High Tibial Osteotomy improves accuracy over conventional techniques, though the current best evidence presented herein must be advanced by Higher quality studies.
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Arthroscopic and Computer-Assisted High Tibial Osteotomy Using Standard Total Knee Arthroplasty Navigation Software
Arthroscopy techniques, 2013Co-Authors: Stephen R. Thompson, Nazar Zabtia, Bradley Weening, Paul ZalzalAbstract:Opening-wedge High Tibial Osteotomy is an increasingly performed procedure for treatment of varus gonarthrosis and correction of malalignment during meniscal transplantation or cartilage restoration. Precise preoperative planning and meticulous surgical technique are required to achieve an appropriate mechanical axis correction. We describe our technique of arthroscopic and computer-assisted High Tibial Osteotomy using commonly available total knee arthroplasty navigation software as an intraoperative goniometer. We believe that our technique, by providing intraoperative real-time guidance of the degree of correction that is accurate and reliable, represents a useful tool for the surgeon who uncommonly performs High Tibial Osteotomy.
Thomas S Thornhill - One of the best experts on this subject based on the ideXlab platform.
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Revision total knee arthroplasty after failed unicompartmental knee arthroplasty or High Tibial Osteotomy.
Clinical Orthopaedics and Related Research, 1995Co-Authors: Thomas J Gill, Gregory W. Brick, Emil H Schemitsch, Thomas S ThornhillAbstract:A retrospective matched-pair comparative analysis was done between 30 total knee arthroplasties following failed High Tibial osteotomies and 30 total knee arthroplasties following failed unicompartmental knee arthroplasties. The groups were matched according to age, gender, type of prosthesis, primary disease, and length of followup. A minimum followup of 2 years was required for inclusion in the study, and the average followup was 3.8 years (range, 2-9 years). The Knee Society Knee Score for the High Tibial Osteotomy group was significantly Higher than that for the unicompartmental arthroplasty group. More osseous reconstructions were required in the unicompartmental revisions. Difficulty with exposure was not significantly greater in the Osteotomy group. Rates of component loosening were not significantly different between the groups. A failed unicompartmental knee arthroplasty and a failed High Tibial Osteotomy can be revised successfully to a total knee arthroplasty. The results confirm that revisions after unicondylar arthroplasty and High Tibial Osteotomy are technically demanding. In this series, the results of total knee arthroplasty following unicompartmental knee arthroplasty approached but did not equal those obtained after High Tibial Osteotomy.
Merrill A. Ritter - One of the best experts on this subject based on the ideXlab platform.
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Total knee arthroplasty after High Tibial Osteotomy.
Clinical orthopaedics and related research, 2000Co-Authors: John B. Meding, Merrill A. Ritter, Philip M. FarisAbstract:Between 1980 and 1995, 95 consecutive total knee replacements were performed at an average of 10 years 4 months after High Tibial Osteotomy. The average age of the 82 patients was 66 years, with a preoperative diagnosis of osteoarthritis in 94 knees. One patient died 6 months after surgery. The followup of the remaining 81 patients (94 knees) averaged 8.6 years (range, 2-17 years). Knee Society knee score at final followup improved to an average of 87.6 points from a preoperative average of 38.1 points. No pain was present in 86.2% of knees, and 12.8% of knees had only mild or occasional pain. Tibial radiolucencies were identified in 12 (12.8%) knees at final followup, and in only four knees were radiolucent lines found about the lateral zones. Only one Tibial component required revision 3 years after surgery. Although no preoperative factor was identified that predisposed to an inferior knee score, function score, or pain score, the severity of the preoperative flexion contracture and the number of previous surgeries did relate to diminished postoperative motion. However, an increased number of patellar radiolucencies were seen in the knees in which the lateral joint line was raised (referenced from the fibular head) a greater degree. The clinical results of total knee replacement after High Tibial Osteotomy appeared similar to those of primary total knee replacement. The previous High Tibial Osteotomy had no adverse effect on the eventual results of a cemented posterior cruciate retaining total knee replacement.
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Total knee arthroplasty after High Tibial Osteotomy. A comparison study in patients who had bilateral total knee replacement.
The Journal of bone and joint surgery. American volume, 2000Co-Authors: John B. Meding, Merrill A. Ritter, E M Keating, Philip M. FarisAbstract:Background The outcome of total knee replacement after High Tibial Osteotomy remains uncertain. We hypothesized that the results of total knee replacement with or without a previous High Tibial Osteotomy are similar. Methods The results of a consecutive series of thirty-nine bilateral total knee arthroplasties performed with cement at an average of 8.7 years after unilateral High Tibial Osteotomy were reviewed. There were twenty-seven men and twelve women. Preoperatively, the knee scores according to the system of the Knee Society were similar for all of the knees; however, valgus alignment and patella infera were more common in the knees with a previous High Tibial Osteotomy. Bilateral total knee replacement was staged in seven patients and was simultaneous in thirty-two patients. The results of the total knee arthroplasties were retrospectively reviewed with respect to the knee and function scores according to the system of the Knee Society, the radiographic findings, and the complications. Results Intraoperatively, no notable differences were identified in the number of medial, lateral, or lateral patellar releases required. However, less lateral Tibial bone was resected in the group with a previous High Tibial Osteotomy (average, 3.3 millimeters) than in the group without a High Tibial Osteotomy (average, 7.5 millimeters). The average duration of follow-up was 7.5 years (range, three to sixteen years) in the group with a previous High Tibial Osteotomy and 6.8 years (range, two to ten years) in the group without a High Tibial Osteotomy. At the time of the final follow-up, the knee and function scores were similar for the two groups (89.0 and 81.0 points, respectively, for the group with a previous High Tibial Osteotomy, and 89.6 and 83.9 points, respectively, for the group without a High Tibial Osteotomy). Although more knees were free of pain in the group without a previous High Tibial Osteotomy (thirty-six) than in the group with a previous Osteotomy (thirty-three), this difference was not found to be significant with the numbers available (p = 0.4810). Knee alignment and stability, femoral and Tibial component alignment, and range of motion also were similar in both groups postoperatively. One allpolyethylene Tibial component was revised in the High Tibial Osteotomy group. Two knees in each group required manipulation. There were no deep infections. Conclusions While patients with a previous High Tibial Osteotomy may have important differences preoperatively, including valgus alignment, patella infera, and decreased bone stock in the proximal part of the tibia, the present study suggests that the clinical and radiographic results of primary total knee arthroplasty in knees with and without a previous High Tibial Osteotomy are not substantially different. In our relatively small group of patients, the previous High Tibial Osteotomy had no adverse effect on the outcome of the subsequent total knee replacement.