High tibial osteotomy and unicondylar knee arthroplasty are preferred surgical treatment methods of medial compartmental arthrosis on young active patients. A revision with total knee arthroplasty might be needed in conditions such as a continuous arthritic change on tibial osteotomy and unicondylar knee arthroplasty, pain, loosening implants, infection or periprostatic fracture.
Technical complexity of revision with total knee arthroplasty after high tibial osteotomy is highlighted on many studies. The reasons of this complexity can be listed as preoperative malalignment, instability, joint stiffness, patella baja, surgical old scar, and existence of implants. To minimize the complexities of arthroplasty practice after osteotomy, careful preoperative planning, appropriate surgical incision, few bone cuts, careful provision soft tissue balance, patellar accommodation, and height adjusting is required.
Revision of unsuccessful unicondylar knee arthroplasty is harder than primary knee prosthesis due to loss of bone and possible ligament instability. Ten-year revision rate of unicondylar knee arthroplasty is in between 8% and 17.5%, and the most common reason of this is aseptic loosening and advance of arthritis. Tibial and femoral bone loss may be a problem after the revisions of unicondylar knee arthroplasty. Application of primary total knee arthroplasty after the practice of bone otograft to the area with bone loss, and if not applicable, using revision systems, increases stability and cater to apply further suitable revisions.