Total Knee Prosthesis After Valgus Osteotomy of the Tibia

The need for a total knee arthroplasty (TKA) after a high tibial osteotomy (HTO) presents several difficulties. The osteotomy induces a bony deformity that can lead to unbalanced bone cuts if the resection is based on ligament balancing techniques. This potential difficulty should be considered before surgery, anticipated, and planned for with a thorough clinical and radiologic examination. Specifically, radiographs should include: