Does a Previous High Tibial Osteotomy (HTO) Influence the Long-term Function or Survival of a Total Knee Arthroplasty (TKA)?

 High tibial osteotomy (HTO) is a well established technique for the treatment of medial osteoarthritis ofthe knee with varus malalignment. The outcome of total knee arthroplasty (TKA) after HTO remains uncertain.The aim of this paper is to revise the literature with the aim of answering the following question: Does a previous (HTO)influence the long-term function or survival of a TKA?. The search engine was MedLine. The keywords used were: total knee arthroplasty after high tibial osteotomy. One hundred and ten articles were found. Of those, only 19 were selected and reviewed because they were strictly focused on the topic and the question of this article. The reports published so far have a low grade of evidence (levels III and IV). Most of them are prospective case series (level IV). One is a systematic review of level III studies reported in 2009. Two recent studies based in a great number of cases (registers) showed similar survival in the 2 groups: around 92% at 10 years, and 88% at 15 years. The review of the literature suggests that a previous HTO does not influence the function or survival of a TKA in the long-term.