Results of posterior cruciate-retaining unconstrained total knee arthroplasty after proximal tibial osteotomy for osteoarthritis - A prospective cohort study

The purpose of the study was to investigate the results of posterior crucia te ligament (PCL)-retaining total knee arthroplasty (TKA) after previous pr oximal closed wedge tibial osteotomy for degenerative arthritis according t o the technique recommended by Coventry and Insall. Thirty-five patients wi th previous proximal tibial osteotomy were matched to 35 patients without p revious osteotomy according to age, sex, and Knee Society patient category. TKA after osteotomy was technically more difficult, often requiring a more extensive exposure. Complications were similar in the two groups, but an e xtended hematoma was more common in patients with previous osteotomies (2 p atients) than in those with primary arthroplasty (I patient). Knee Society scores were significantly lower in those with previous osteotomy, primarily because of decreased anteroposterior stability and pain. No significant di fferences were found in function scores, range of motion, or alignment. How ever, overall results of this PCL-retaining unconstrained TKA did not match those reported after PCL-substituting TKA.