Total knee arthroplasty after osteotomies around the knee

Osteotomies around the knee are procedures that have shown excellent results to treat unicompartmental arthritis delaying the need for knee replacement. Despite the good results, benefits generally deteriorate with time leading to a total knee arthroplasty (TKA) for progression of osteoarthritis and involvement of the other compartments. Conversion of osteotomy to TKA is more surgically demanding compared with a primary prosthesis; in this paper, we analyze surgical difficulties that surgeons can found to perform TKA after an osteotomy around the knee; according to the literature we analyze surgical steps that can differ from standard primary surgery, including skin incision, hardware removal, residual tibial and femoral deformities and balancing of soft tissue.