Total Knee Arthroplasty for Severe Valgus Deformity

Ranawat, Amar S.; Ranawat, Chitranjan S.; Elkus, Mark; Rasquinha, Vijay J.; Rossi, Roberto; Babhulkar, Sudhir

doi:10.2106/00004623-200509001-00010

Cited by 151 publications

(113 citation statements)

References 7 publications

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“…The level of resection was dependent on the deformity and the stability of the knee in extension. Massive valgus deformity associated with hyperextension/hyperlaxity usually requires a reduced depth of resection of the femur [14,44], whereas varus with fixed flexion deformity often requires a deeper tibial resection depth to compensate for the eroded tibial bone and a more proximal femoral resection to obtain full extension. Another technique to accomodate for a deep posteromedial defect is to reduce the size of the tibial tray and lateralize the tibial component slightly, while resecting the overhung medial tibial bone (tibial reduction osteotomy) [13].…”

Section: Surgical Techniquementioning

confidence: 99%

Total knee arthroplasty in patients with substantial deformities using primary knee components

Muylder

Victor

Kaminski

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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Section: Surgical Techniquementioning

confidence: 99%

Total knee arthroplasty in patients with substantial deformities using primary knee components

Muylder

Victor

Kaminski

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…Vorbemerkungen Die Versorgung einer kontrakten Valgusgonarthrose mit einem kondylären Implantatsystem ist unverändert mit dem Problem verbleibender ligamentärer Dysbalancen, dezentrierten Patellaverläufen und tendenziell schlechteren "Knee"-Scores als beim Varusknie behaftet [6,7,8,9,15,19,22,29,32,35].…”

Section: Die Sagittale Gleitosteotomie Des Lateralen Kondylus Nach Brunclassified

“…Zu dem Release des Tractus iliotibialis werden verschiedene Modifikationen angegeben (I-Cutting, Zbzw. VY-Plastiken, Quer-/Schräginzisio-nen), Außen band-und Popliteusinsertion werden als superiostaler Flap vom Epiconylus lateralis abgelöst [1,8,9,15,19,22,30,32].…”

Section: Die Sagittale Gleitosteotomie Des Lateralen Kondylus Nach Brunclassified

“…Das kontrakte Valgusknie wird über-wiegend über einen sequentiellen Release der kontrakten lateralen Strukturen adressiert [1,7,8,22,30,32] oder über eine zusätzliche Raffung medialer Kaspelbandstrukturen [15,19], vornehmlich über den medioparapatellaren Zugang [1,18,15,19,22,29,30,32]. Es gibt jedoch genügend Hinweise, dass der laterale parapatellare Zugang (Standardzugang des Autors beim Valgusknie) mit oder ohne Osteotomie der Tuberositas tibiae entscheidende Vorteile beim Valgusknie bietet: das parapatellare Release ist Bestandteil des Zugangs und verbessert das postoperative femoropatellare Alignement [2,3,17,18,36].…”

Section: Komplikationenunclassified

“…Daraus folgt, dass wir konsequent den lateralen Release in Flexion durchführen. Ein Release zunächst in Streckung, wie in der Literatur beschrieben [8,32], kann es in Einzelfällen zu einer unkontrollierbaren Instabilität des lateralen Beugespalts führen mit der Konsequenz eines mögli-chen "spin out" des "mobile bearing"-Inlays oder sogar einer Luxation der Knieprothese [12,27,34].…”

Section: Komplikationenunclassified

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Die sagittale Gleitosteotomie des lateralen Kondylus nach Briard beim Oberflächenersatz des kontrakten Valgusknies

Bremer¹,

Orth²,

Fitzek³

et al. 2012

Oper Orthop Traumatol

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A total of 79 patients (61 women, 18 men, average age 71 years at the time of surgery) with fixed valgus deformities were operated between June 2001 and December 2010 using TKA and sliding osteotomy of the lateral femoral condyle. The preoperative valgus angle under defined valgus and varus stress was 19.5° (8-40), postoperative 4.7° (2-11). Mean medial angle (valgus stress) of the follow-up was 2.1° (0.5-5°), lateral angle (varus stress) 2.3° (0.5-5°). A total of 35 patients were followed-up, at a mean of 73.3 month (24-109 months). The postoperative Knee Society Score was 95 points (56-100 points), while the postoperative Function Score was 90 points (55-100 points) postoperatively. The Oxford Score improved from 22 points (3-43 points) preoperatively to 45 points (21-48 points) postoperatively. One knee had to be revised due to infection, one knee due to non-union of the tibial tubercle. Finally, there were 3 cases with complications associated with the procedure due to the sliding osteotomy of the lateral femoral condyle; all were revised successfully. No conversion to a semi-constrained or constrained knee prosthesis was necessary.

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Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study

Kage,

Kono,

Tomita

et al. 2024

J. exp. orthop.

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PurposeThe efficacy of medial pivot total knee arthroplasty (MP TKA) in treating valgus knees that may cause medial instability is unknown. The purpose of this study was to investigate the in vivo kinematics of MP TKA for the valgus knees and compare them to those for the varus knees.MethodsThe kinematics of 19 valgus knees and 19 varus knees operated in the MP TKA were investigated under fluoroscopy during squatting using a two‐ to three‐dimensional registration technique. Accordingly, the valgus and varus knees were evaluated and compared in terms of knee flexion angle, anteroposterior translation for the medial and lateral low contact points, axial rotation and valgus–varus angle of the femoral component relative to the tibial component, as well as kinematic pathways.ResultsThe knee flexion angle was found to be identical in both knees. There was no anterior translation on the medial side of the valgus knees, and no difference was detected between the two knees. On the lateral side, posterior translation was observed in both knees, with no difference between the two. Femoral external rotation was observed in both knees, and no difference was detected between the two. There was no valgus–varus change in the valgus knees, nor was there a difference between the two knees. The valgus knees demonstrated MP motion, whereas the varus knees demonstrated MP motion and bicondylar rollback.ConclusionThe medial side of the valgus knees treated with MP TKA showed comparable stable kinematics to the varus knees. The MP TKA is an effective procedure for valgus knees to stabilize the medial compartment.Level of EvidenceLevel Ⅲ.

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Total Knee Arthroplasty for Severe Valgus Deformity

Cited by 151 publications

References 7 publications

Total knee arthroplasty in patients with substantial deformities using primary knee components

Total knee arthroplasty in patients with substantial deformities using primary knee components

Die sagittale Gleitosteotomie des lateralen Kondylus nach Briard beim Oberflächenersatz des kontrakten Valgusknies

Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study

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