Abstract
Osteotomy around the knee preceding total knee arthroplasty (TKA) has long been perceived
as a factor contributing to higher complication rates and increased risk of revision
as compared with primary TKA. However, recent systematic reviews and large registry
analysis have not been able to confirm this perception. Technical difficulties and
slightly higher complication rates can be attributed to older lateral closing wedge
tibial osteotomy techniques and are not reported for the more frequently performed
tibial medial opening wedge techniques. In the first part of this article, the latest
information on this topic will be summarized. The second part of this article deals
with osteotomies combined with TKA. Guidelines will be presented for the treatment
of osteoarthritic patients with large leg deformities or extra-articular deformities.
We aim to describe the latest advances in preoperative planning techniques, including
a stepwise decision-making process and a review of the literature about this topic.
Keywords
total knee arthroplasty - extra-articular deformity - supracondylar femoral osteotomy
- high tibial osteotomy
