SIMULTANEOUS CONTRALATERAL HIGH TIBIAL OSTEOTOMY DURING TOTAL KNEE ARTHROPLASTY: A NEW PERSPECTIVE IN ORTHOPEDIC SURGERY.

Background: This study aimed to demonstrate the clinical outcomes of simultaneously applied two different surgical procedures in patients with bilateral gonarthrosis of varying degrees. Methods: Patient files registered in our clinic between 2016 and 2021 were retrospectively reviewed, and 35 patients who underwent simultaneous total knee arthroplasty (TKA) and high tibial osteotomy (HTO) were identified. Patient selection was based on preoperative ortho-radiograms, and surgeries were performed on patients having grade IV osteoarthritis in one knee and grade II osteoarthritis in the contralateral knee. The study included 32 patients, of whom 3 were excluded due to irregular follow-ups, morbid obesity, and multiple comorbidities. The mean follow-up period was 48 months. Results: All patients were female, with a mean age of 60.19±3.28 years. The mean postoperative Visual Analog Scale scores and modified Oxford Knee Scores of the HTO and TKA groups were significantly lower than their mean preoperative scores (p=0.0001 for both). None of the knees that underwent HTO required revision or conversion to TKA. Furthermore, no HTO plates were removed in any patient. Conclusions: Simultaneous application of HTO and TKA to both knees can result inclinically and functionally successful outcomes in appropriately selected cases, in line with the surgeon's recommendation and the patient's preference. The correction achieved in both the anatomical and mechanical axes in a single session positively contributes to clinical and functional outcomes. Furthermore, performing two different surgeries under a single anesthesia session provides economic and psychological benefits to the patient.