Review Question - QID 6018

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TKA in Patella Baja (Prior HTO) QID: 6018 (SAE07HK.58)

QID 6018 (Type "6018" in App Search)

Figure 35 shows the AP radiograph of a patient who underwent a previous upper tibial osteotomy (UTO). The patient may be at risk for which of the following during total knee arthroplasty (TKA)?

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Bone loss

73/988

Patella alta

23%

228/988

Myositis ossificans

24/988

Fracture

26%

252/988

Instability

41%

407/988

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The results of TKA for patients with a prior UTO are reported to be slightly suboptimal. The major problems are patella baja, difficulty in exposure, and instability. Most of the patients exhibit some degree of instability prior to TKA, and ligamentous balancing may be difficult. Ligamentous structures are at risk of rupture during the difficult exposure. The problem of ligamentous balancing is exacerbated by the change in the joint slope that can occur after UTO.