VIDEO: Respect indications for best results with revision TKA, tibial tubercle osteotomy
Click Here to Manage Email Alerts
GRAPEVINE, Texas — At one center, tibial tubercle osteotomy was performed in 20% of 700 total knee arthroplasty cases in a 10-year period, Sébastien Lustig, MD, PhD, said at the American Association of Hip and Knee Surgeons Annual Meeting.
“The key message of this study with quite large numbers, because I think it’s the largest monocentric study published today about combining tibial tubercle osteotomy (TTO) with revision total knee, is that it does work, but you have to select indications because there are significant complications to consider,” Lustig, who is chair of the orthopedic department at Lyon University Hospital in Lyon, France, told Healio.
The in-office follow-up of patients in the study who underwent TTO during revision TKA was focused on complication rates, bone healing and overall outcomes, he said.
There was a 15% complication rate in these patients and 6% of these patients were reoperated, according to Lustig. Tibial tubercle fracture and delayed bone union were the main complications. “But, eventually, these patients, that’s the good message ... have been doing very well,” he said.
Outcomes at a mean follow-up of 4 years (minimum of 2 years) showed good range of motion and functional outcomes, according to Lustig.
The average delay to bone healing was 3 months. The fastest bone healing of the TTO occurred at 6 weeks and the longest time to healing was at about 2 years, he said. “But usually, after 3 months, they get healed and the outcome is quite satisfactory.”
Lustig said revision TKA performed with TTO is not a main option to consider, but should be used only for challenging cases.
“For us, indications are stiff knees, patella baja, previous TTO or a challenging case where you know you are going to have some difficulties to remove the cement or all of the implants,” he told Healio.
Collapse
Batailler C, et al. Paper 46. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 3-6, 2022; Grapevine, Texas.
Read more about
Click Here to Manage Email Alerts