Total Knee Arthroplasty for Profound Varus Deformity

Mullaji, Arun; Padmanabhan, Vinod; Jindal, Gaurav

doi:10.1016/j.arth.2005.04.009

Cited by 113 publications

(56 citation statements)

References 11 publications

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“…Therefore, we used long and additional oblique Wxation pins as suggested in the previous studies [33 , 34]. Flex gap med-ext gap med >3 mm, n(%) --4 (7) 10 (18) 11 (10) In order to minimize the inaccuracy caused by deXexion of saw blades, we used for all cases new saw blades and were cautious during the cutting process.…”

Section: Precision Of Tibial and Femoral Resection In Navigated Tkamentioning

confidence: 99%

“…Incorrect balancing leads to postoperative pain and instability in the short term [5,6] and loosening, polyethylene wear and failure in long term [1,7]. Though techniques of soft tissue and gap balancing are described in the literature [8][9][10], soft tissue management in total knee arthroplasty is still a subjective maneuver. There are a variety of deformities, each of which needs to be addressed diVerently and individually.…”

Section: Introductionmentioning

confidence: 95%

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Precision of Ci-navigated extension and flexion gap balancing in total knee arthroplasty and analysis of potential predictive variables

Fickert

Jawhar

Sunil

et al. 2011

Arch Orthop Trauma Surg

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Section: Precision Of Tibial and Femoral Resection In Navigated Tkamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Precision of Ci-navigated extension and flexion gap balancing in total knee arthroplasty and analysis of potential predictive variables

Fickert

Jawhar

Sunil

et al. 2011

Arch Orthop Trauma Surg

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show abstract

“…Leopold et al6) reported no instability on the clinical and physical assessment after treatment with suture-anchor reattachment to the bone in four cases (0.7%). Mullaji et al7) also reported that the distal end of a completely detached MCL was sutured to the pes insertion in two cases (1.2%).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Complete Distal Release of the Medial Collateral Ligament and Medial Epicondylar Osteotomy during Ligament Balancing in Varus Knee Total Knee Arthroplasty

et al. 2013

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BackgroundDuring ligament balancing for severe medial contracture in varus knee total knee arthroplasty (TKA), complete distal release of the medial collateral ligament (MCL) or a medial epicondylar osteotomy can be necessary if a large amount of correction is needed.MethodsThis study retrospectively reviewed 9 cases of complete distal release of the MCL and 11 cases of medial epicondylar osteotomy which were used to correct severe medial contracture. The mean follow-up periods were 46.5 months (range, 36 to 78 months) and 39.8 months (range, 32 to 65 months), respectively.ResultsThere were no significant differences in the clinical results between the two groups. However, the valgus stress radiograph revealed significant differences in medial instability. In complete distal release of the MCL, some stability was obtained by repair and bracing but the medial instability could not be removed completely.ConclusionsMedial epicondylar osteotomy for a varus deformity in TKA could provide constant medial stability and be a useful ligament balancing technique.

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“…The extent of medial release was classified into 4 stages and staged medial releases were performed in this study: release of the deep medial collateral ligament (stage 1), release of the posterior oblique ligament or semimembranous insertion (stage 2), release of the posterior capsule (stage 3), and release of the distal superficial collateral ligament or medial epicondylar osteotomy (stage 4)1,10-13).…”

Section: Methodsmentioning

confidence: 99%

“…Bone defects in knees with advanced osteoarthritis can cause profound varus deformity1), which can lead to medial soft tissue contracture. Depending on the extent of deformity, a medial release is necessary during total knee arthroplasty (TKA)2,3).…”

Section: Introductionmentioning

confidence: 99%

Relationship between Tibial Bone Defect and Extent of Medial Release in Total Knee Arthroplasty

Nam

Kwak

Kim

et al. 2012

Knee Surg Relat Res

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PurposeTo understand the relationship between tibial bone defect and extent of medial release in total knee arthroplasty.Materials and MethodsWe evaluated 32 knees in 22 patients with variable degrees of tibial bone defect on medial plateau has undergone total knee arthroplasty. In this study, 31 cases had been diagnosed as degenerative osteoarthritis and 1 case was osteonecrosis. We excluded cases with infection, traumatic arthritis, or neuropathic joints. With regard to gender, 29 cases were female and 3 cases were male. The following relationships were analyzed: preoperative degrees of tibial bone defect and varus deformity; the femorotibial angle of both weight-bearing whole extremity radiogram, distractive stress radiogram, and the extent of medial release.ResultsAverage tibial bone defect was 9.8±4.1 mm. Average femorotibial angle on weight-bearing whole extremity radiograph was varus 10.0°±6.2°. Average femorotibial angle on distractive stress radiograph was varus 0.7°±4.6°. Statistically the extent of medial release showed no significant relationship with the degree of tibial bone defect and femoro-tibial angle of whole extremity radiogram. However, it revealed a statistically significant relationship with the femorotibial angle on distractive radiogram (r=0.465, p=0.007).ConclusionsPreoperative distractive stress radiograph might be a useful method to predict the extent of intraoperative medial release during total knee arthroplasty.

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Total Knee Arthroplasty for Profound Varus Deformity

Cited by 113 publications

References 11 publications

Precision of Ci-navigated extension and flexion gap balancing in total knee arthroplasty and analysis of potential predictive variables

Precision of Ci-navigated extension and flexion gap balancing in total knee arthroplasty and analysis of potential predictive variables

Comparison of Complete Distal Release of the Medial Collateral Ligament and Medial Epicondylar Osteotomy during Ligament Balancing in Varus Knee Total Knee Arthroplasty

Relationship between Tibial Bone Defect and Extent of Medial Release in Total Knee Arthroplasty

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