Extra‐articular biceps tendon supplement release in total knee arthroplasty for valgus deformity combined with severe flexion contracture

Abstract

To investigate the efficacy of extra‐articular biceps tendon supplement (EBS) release in the treatment of valgus knee with severe flexion contracture. We retrospectively studied 27 patients who received EBS release for valgus knee combined with severe flexion contracture from 2018 to 2021. The full‐length radiograph of the lower limbs in a standing position was taken before and after the operation, and the tibiofemoral angles before and after the operation were measured on the full‐length radiograph of the lower limbs. Knee joint motion measurement and KSS scoring were performed before and after the operation (3 months, 6 months, and 1 year), and the obtained data were compared before and after the operation to evaluate clinical results. Compared with preoperation, postoperative HKA (p < 0.01), ROM at 3 months (p < 0.01), 6 months (p < 0.01), and 1 year (p < 0.01) were significantly improved, and KSS scores at 3 months (p < 0.01), 6 months (p < 0.01), and 1 year (p < 0.01) were significantly improved. Our EBS release has good clinical results for the treatment of valgus knee with severe flexion contracture.

Correction of Sagittal Deformity with Bone Resection and Soft Tissue Releases

“…Grade III deformities are considered severe (4). They can be managed in a multitude of ways including further ligamentous, capsular, and musculotendinous releases and additional bony resection (4,29). Adequate bony resection of the distal femur plays a crucial role in achieving optimal outcomes.…”

“…Hamstring and biceps tendon tenotomy are techniques that may be used in rare circumstances where the FFD is severe (29). In the setting of a severe valgus knee with FFD, after releasing the IT band, posterior joint capsule, lateral collateral ligament, and popliteal tendon, extraarticular biceps tenotomy showed significant improvement in ROM compared to preoperative values (29). This technique requires a second incision and should only be employed if necessary.…”

“…4 They can be managed in a multitude of ways including further ligamentous, capsular, and musculotendinous releases and additional bony resection. 4,29 Adequate bony resection of the distal femur plays a crucial role in achieving optimal outcomes. It is important to resect the necessary amount of distal femur to achieve proper alignment, correct joint line discrepancies, and restore balanced flexion and extension gaps.…”