Total knee arthroplasty after dome vs closed wedge high tibial osteotomy: a comparative study
Makaleler > Tam Makale · 2026
Yazarlar: Omar Aljasim, Kayhan Özcan, Arman VAHABİ, Melekper Elcil KAYA BİÇER, Semih AYDOĞDU, Hakki Sur
Journal of Cartilage & Joint Preservation, Uluslararası, Scopus, 2026, cilt 6, ss 100288-100288
DOI: 10.1016/j.jcjp.2026.100288
Özet
Introduction Converting previously operated knees with high tibial osteotomy (HTO) to total knee arthroplasty (TKA) poses significant technical challenges due to the altered anatomy and geometry of the proximal tibia. Objectives This study compared prosthetic component positioning in TKAs performed after closed wedge HTO (CWHTO) versus those performed after dome HTO (DHTO). Methods A total of 36 TKAs performed with a history of HTO (19 CWHTO and 17 DHTO) were retrospectively reviewed. Demographic variables, anatomical femorotibial angle, and TKA components alignment were assessed. Patellar position was assessed using the Insall–Salvati ratio. Additionally, joint line height and posterior tibial slope were recorded. Tibial tubercle osteotomy, and perioperative complications were evaluated. Results There were no differences in the demographic variables between both groups. The femorotibial angle and prosthesis alignment was comparable between the CWHTO and DHTO groups ( P > .05). Tibial tubercle osteotomy was performed in the CWHTO group in 1 knee (5%) and in the DHTO group in 4 knees (24%), with no statistically significant difference between the groups ( P = .17). The Insall–Salvati ratio was comparable between both groups preoperatively and postoperatively ( P = .85, P = .58). No significant differences were observed between the groups in terms of joint line height, posterior tibial slope, or complication rates. Tibial augmentation utilized only in DHTO group ( P = .04, ). Conclusions Radiological outcomes and prosthesis alignment of TKA following both HTO were comparable; however, the intraoperative approach appeared to be more technically demanding in the DHTO group.