ISAKOS: 2019 Congress in Cancun, Mexico

2019 ISAKOS Biennial Congress ePoster #1201


Double Level Osteotomy is Less Invasive than Total Knee Arthroplasty

Manabu Akagawa, MD, Akita, Akita JAPAN
Hidetomo Saito, MD, PhD, Akita, Akita JAPAN
Kimio Saito, MD, Akita, Akita JAPAN
Yoshiaki Kimura, MD, Akita, Akita JAPAN
Yoichi Shimada, MD, PhD, Prof., Akita, Akita JAPAN

Akita City Hospital, Akita, Akita, JAPAN

FDA Status Not Applicable


The invasiveness of double level osteotomy was less than total knee arthroplasty



The result of around the knee osteotomy for osteoarthritis (OA) have been improved, and recent years, combined osteotomies such as Double level osteotomy (DLO) and Double level triple osteotomy (DLTO) have been performed for advanced OA. However, the invasiveness of these combined osteotomies is still unclear. So the purpose of this study is to investigate surgical invasiveness of combined osteotomies compared to arthroplasty.


Patients who underwent combined osteotomies (DLO, DLTO) or total knee arthroplasty (TKA) between April 2010 and January 2017 were recruited. In a total of 38 patients, involving 42 knees, operation time (OT) and total volume of blood loss (BL) during the operation, and the trends in the data for hemoglobin (Hb), white blood cells (WBC), creatine kinase (CK), and C-reactive protein (CRP) for up to 2 weeks after surgery were evaluated.


The operation time of DLTO was significantly longer than TKA. There was no significant difference between the groups in BL, WBC, Hb, and CK. In TKA, CRP at 1st and 3rd postoperative day was significantly higher than DLO, and the significance remained until 14th postoperative day.


In the present study, the surgical invasiveness represented by CRP was significantly higher in TKA than in DLO, and the invasiveness was remained until 2 weeks postoperatively. From the view of invasiveness, combined osteotomies may be useful for advanced knee OA.