We designed a new osteotomy technique in order to get a consistent extension gap along with a tibial polyethelene insert in TKRA. The results were compared to the independent osteotomy technique.

Forty two patients were divided into an independent osteotomy group and a linked osteotomy group according to the technique adopted. In the linked osteotomy group, the extension gap was made by using a linker which was designed to provide a consistent gap between the distal femur and the proximal tibia during knee extension. The widths of the extension gap and the polyethylene thickness was compared between the two groups.

The extension gap of the independent osteotomy group was 18.1 ± 4.2 mm (2SD) and that of the linked femorotibial osteotomy group was 20.3 ± 1.3 mm (2SD). The polyethylene thickness was 8.1 ± 2.6 mm (2SD) in the independent group and 9.4 ± 0.9 mm (2SD) in the linked group.

This linked femorotibial osteotomy technique provided an improved method for obtaining a tibial insert matched extension gap in TKRA. This technique might also increase the longevity of the polyethylene insert.