• M A Vives-Barquiel, A Torrents, L Lozano, J C Martínez-Pastor, F Maculé, J M Segur, and D Popescu.
• Resident Trauma and Orthopaedic Surgery Department, Hospital Clínic Barcelona, Villarroel 170, Barcelona, Spain. vives1@clinic.ub.es.
• Arch Orthop Trauma Surg. 2015 Oct 1; 135 (10): 1445-51.

IntroductionStiffness after a total knee arthroplasty (TKA) is one of the most common post-operative complications. The purpose of this study is the evaluation of the effectiveness of TT proximalization osteotomy of improving a lack of flexion and secondary pain in patella baja (infera) post-TKA.Materials And MethodsBetween April 2007 and July 2012, TT proximalization osteotomy was performed on 21 patients. The average preoperative flexion was 70° (in a range of 60-80). Clinical pre- and post-operative evaluations were performed with Knee Society Score, Western Ontario and McMaster Universities Arthritis Index scales and a satisfaction survey. Modified Blackburn-Peel index and Portner angle were used to evaluate patellar height.ResultsAfter an average follow-up of 35 months (range 18-48), an average flexion of 100° (range 90-100) and an overall satisfaction were obtained. Clinical scores improved significantly. The Blackburn-Peel index and Portner angle improved significantly from 0.3 (range 0.1-0.5) to 0.4 (0.3-0.5) and from 9 (3-15) to 12 (9-18), respectively. Three patients showed no signs of osteotomy consolidation. However, this was not linked to a lack of extension or an increase in local pain.ConclusionTT proximalization osteotomy provides satisfactory results in improving a lack of flexion and pain in patella baja post-TKR.

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