A Novel Medial Soft Tissue Release Method for Varus Deformity during Total Knee Arthroplasty: Femoral Origin Release of the Medial Collateral Ligament

Lee, Seung Yup; Yang, Jae Hyuk; Lee, Yong In; Yoon, Jung Hwan

doi:10.5792/ksrr.2016.28.2.153

Cited by 14 publications

(7 citation statements)

References 20 publications

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“…Postoperative rehabilitation for our patient was the same as for patients without bone grafting in that weight-bearing and continuous passive motion is not limited. In cases with patients who undergo further release of medial structures such as the femoral origin of the MCL to obtain a rectangular mediolateral gap in some severe varus knees, a hinged brace is used for six weeks postoperatively [ 7 ].…”

Section: Methodsmentioning

confidence: 99%

Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty

Yoon

Seo

Shin

2017

BMC Musculoskelet Disord

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BackgroundThe use of autogenous bone graft is a well–known technique for reconstruction of tibial bone defects in primary total knee arthroplasty (TKA). In cases where the size of the bone graft is inappropriate, the stability of bone graft fixation and subsequent bone graft to host bone incorporation may be compromised. We describe a simple and reliable technique of reconstruction in a proximal tibia bone defect at the time of primary TKA by using autogenous onlay bone graft (AOBG).MethodsRecords were reviewed of 19 patients (mean age, 72 years) who underwent primary TKA using AOBG without the additional allogenous bone or metal augments, between August 2013 and August 2014.ResultsMean Knee Society score (KSS) in the 22 knees was significantly higher postoperatively than preoperatively (92 ± 4 vs. 30 ± 7, P < 0.001). The mean range of motion (ROM) in the 22 knees, which was 106 ± 12° preoperatively, improved to 112 ± 10° at last follow-up, but this this difference was not significant (P = 0.32). No migration of implants and presence of radiolucent lines at the bone cement-prosthesis interface were observed. Furthermore, the serial radiographs of 19 patients had a mean time of 3.2 months (range, 2.7–4.4 months) for solid union with cross trabeculation between the proximal tibial bone and graft.ConclusionsThis simple AOBG supplement technique may biologically promote graft to host bone healing by enhancing fixation stability without the additional fixatives and assist the surgeon in managing the varying nature of uncontained bone defects.Trial registrationTrial registration number: KCT0002328, May 15, 2017.

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Section: Methodsmentioning

confidence: 99%

Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty

Yoon

Seo

Shin

2017

BMC Musculoskelet Disord

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“…All participants in the study received spinal anesthesia; they received 2.5 ml of 0.5% hyperbaric bupivacaine intrathecally. All patients underwent routine primary jig-based total knee arthroplasty using medial parapatellar approach using a posterior stabilized cemented implant with soft tissue releases carried out sequentially depending on the severity of the derformity aiming to achieve equal gaps in both flexion and extension [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Pre-emptive Analgesia in Total Knee Arthroplasty During Early Post-operative Periods

Ssamy,

Patro,

Jeyaraman

et al. 2023

Cureus

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Introduction: Pre-emptive analgesia is expected to decrease post-operative pain. The degree of soft tissue release is directly related to preoperative deformity; we presume the severity of pain has a similar correlation in patients undergoing total knee arthroplasty (TKA). The main purpose of this research was to evaluate the effects of pre-emptive analgesia of different drugs in TKA with different degrees of preoperative genu varus. Methods: In this prospective observational study, 67 patients were enrolled with different degrees of genu varus deformity. They were subdivided into two groups: those with ≥15° and those with <15° varus deformities of the knee. Etoricoxib 60 mg and pregabalin 75 mg were administered orally in all the patients as pre-emptive analgesia two hours before surgery. Parameters such as the amount of soft tissue release, visual analog score (VAS), knee range of motion, complications, etc. were documented from the pre-operative period to 72 hours post-TKA. Results: With pre-emptive analgesia in post-TKA patients, the VAS score demonstrated a statistically significant difference at 24, 48, and 72 hours. The comparison of intraoperative flexion between <15° and ≥15° showed a statistically significant difference with pre-emptive analgesia in post-TKA patients. Conclusion: The use of etoricoxib 60 mg and pregabalin 75 mg, two hours before surgery reduced the pain scores in patients undergoing TKA with different degrees of genu varus and correlated with intraoperative parameters associated with soft medial tissue release for genu varus.

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“…Step 1. osteophyte removal and release of the deep medial collateral ligament; Step 2. posterior oblique ligament, and semimembranosus release; Step 3. superficial medial collateral ligament release; and Step 4. pes anserinus tendon release [11].…”

Section: Methodsmentioning

confidence: 99%

Preoperative Clinical Correctability and Prediction of the Prosthesis Type in Total Knee Arthroplasty for ‌Severe Osteoarthritic Varus Deformity

Shahpari

Bagherifard

Rahbar

et al. 2019

J. Res. Orthop. Sci.

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Background: The preoperative identification of patients who might need constrained condylar knee (CCK) prosthesis in total knee arthroplasty (TKA), is essential to ensure the availability of equipment and to address the patients’ expectations accurately. Objectives: In this study, we aimed at investigating if the preoperative features of the patients can provide this data. Methods: A total of 30 patients who underwent primary TKA for severe osteoarthritic genu varum deformity (varus angle ≥20º) were evaluated in this retrospective study. Prosthesis selection was based on preoperative and intraoperative information. Demographic data, preoperative correctability of the deformity, and intraoperative information, including the reduction osteotomy, soft-tissue release, and pie-crust technique, were retrospectively collected. Soft-tissue release was performed in a sequential manner in 3 steps. Results: The study population included 4 males and 26 females with a mean±SD age of 64.6±8.7 years. A CCK prosthesis was used in 11 (36.7%) cases. A significant association was found between the preoperative correctability and the type of prosthesis. In other words, all CCK prostheses were used in patients who were preoperatively non-correctable (P<0.001). Also, the step of release was significantly associated with the type of prosthesis, and CCK prosthesis was used in all patients with step 3 release (P<0.001). Preoperative correctability was significantly related to the step of release, as well. It means that all deformities with step 3 release were preoperatively non-correctable (P=0.008). Conclusion: The preoperative clinical evaluation of correctability could be used in the identification of patients who might need a CCK prosthesis.

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A Novel Medial Soft Tissue Release Method for Varus Deformity during Total Knee Arthroplasty: Femoral Origin Release of the Medial Collateral Ligament

Cited by 14 publications

References 20 publications

Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty

Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty

Evaluation of Pre-emptive Analgesia in Total Knee Arthroplasty During Early Post-operative Periods

Preoperative Clinical Correctability and Prediction of the Prosthesis Type in Total Knee Arthroplasty for ‌Severe Osteoarthritic Varus Deformity

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