Total Knee Arthroplasty After Failed High Tibial Osteotomy

The available literature is divided as to the effect that a previous high tibial osteotomy (HTO) has on the overall outcome of total knee arthroplasty (TKA). However, it is hard to refute that TKA after a failed HTO does present potential challenges to the surgeon. The key issues that potentially influence the outcome of a TKA post-osteotomy have been reviewed. HTO is a good alternative to arthroplasty in selected cases of medial compartment osteoarthritis; however, with the passage of time, these results deteriorate, and the most common means of treating a failed HTO is with revision to a TKA. As a result, the surgeon performing a HTO must be mindful of the potential needs for subsequent TKA and avoid compromising its outcome.