BACKGROUND High tibial osteotomy is commonly performed in young patients with high activity demand. Several studies have reported outcome of HTO. The reported 10-year survival ranged from 79 to 97.6%. The reported 15-year survival ranged from 56 to 65.5%, resulting in the need for conversion to TKA. Primary TKA now provides satisfactory long-term outcome in terms of function and survival. Researches have been conducted to compare clinical outcome between primary TKA and TKA after HTO to see if TKA should be the prior treatment rather than HTO in some cases. But the results were inconsistent. This study aims to compare the risk of revision and other parameters between total knee arthroplasty after high tibial osteotomy and primary total knee arthroplasty. METHODS Searches and screens of the relevant literature were conducted, after which data were extracted and pooled analysis was performed to compare the clinical outcomes between the two groups. RESULTS A total of 14 studies with 144,692 cases were included. Pooled analysis showed significantly more revisions and complications, and more tibial component loosening and impingement in postoperative X-ray in the HTO-TKA group. Surgical complexity during conversion to total knee arthroplasty was summarised and listed in table. CONCLUSION High tibial osteotomy offers satisfactory pain relief and functional outcome in selected patients with high activity demand. However, the need for subsequent TKA should be noted, which might be a technically challenging procedure with significantly higher risk of revision comparing to primary TKA.

中文翻译：

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胫骨截骨术后全膝关节置换术翻修的较高风险：系统评价和最新荟萃分析。

背景技术高胫骨截骨术通常在具有高活动需求的年轻患者中进行。几项研究报告了HTO的结果。报告的10年生存率从79％到97.6％。报告的15年生存率在56％至65.5％之间，因此需要转换为TKA。现在，就功能和生存而言，原发性TKA可提供令人满意的长期结果。已经进行了研究以比较原发性TKA和HTO术后TKA的临床结局，以了解在某些情况下TKA是否应作为先前治疗而非HTO。但是结果不一致。这项研究的目的是比较胫骨截骨术后全膝置换与原发全膝置换的翻修风险和其他参数。方法对相关文献进行搜索和筛选，之后提取数据并进行汇总分析，以比较两组之间的临床结果。结果共纳入14项研究，共144,692例。汇总分析显示，HTO-TKA组术后X线检查显示更多的翻修和并发症，以及更多的胫骨组件松动和撞击。总结为全膝关节置换术的手术复杂性并列于表中。结论高胫骨截骨术可为某些活动需求高的患者提供令人满意的疼痛缓解和功能预后。但是，应注意后续TKA的需要，这可能是一项技术难题，与原发性TKA相比，其翻修风险明显更高。