Total knee arthroplasty with corrective osteotomy for knee osteoarthritis associated with malunion after tibial plateau fracture: a case report

BACKGROUND: When surgeons perform total knee arthroplasty in patients with knee osteoarthritis due to malunion following fractures around the knee joint, corrective osteotomy is recommended for severe deformities. Most such deformities are coronal plane varus or valgus deformities, and reports of sagittal plane flexion or extension deformities are rare. We describe a case in which a one-stage total knee arthroplasty was performed with extension corrective osteotomy in the sagittal plane. CASE PRESENTATION: A 71-year-old Japanese man presented with left knee pain. He had knee osteoarthritis associated with malunion after a tibial plateau fracture. Plain radiography showed a varus deformity in the coronal plane and a marked flexion deformity in the sagittal plane. We performed total knee arthroplasty concurrently with extension corrective osteotomy using a long stem. Full weight bearing was permitted at 6 weeks postoperatively, and the patient was able to walk without assistance. CONCLUSIONS: This surgical method appears to be beneficial for shortening the duration of treatment and improving knee function.