The management of osteoarthritis of the knee associated with patellar instability secondary to external tibial torsion > 45 degrees is challenging. Patellofemoral biomechanics in these patients cannot be achieved by intra-articular correction using standard techniques of total knee replacement. We reviewed seven patients (eight knees) with recurrent patellar dislocation and one with bilateral irreducible lateral dislocation who had undergone simultaneous total knee replacement and internal tibial derotational osteotomy. All had osteoarthritis and severe external tibial torsion. The mean follow-up was for 47.2 months (24 to 120). The mean objective and functional Knee Society scores improved significantly (p = 0.0001) from 29.7 and 41.5 pre-operatively to 71.4 and 73.5 post-operatively, respectively. In all patients the osteotomies healed and patellar stability was restored. Excessive external tibial torsion should be identified and corrected in patients with osteoarthritis and patellar instability. Simultaneous internal rotation osteotomy of the tibia and total knee replacement is a technically demanding but effective treatment for such patients.

Download full-text PDF

Source
http://dx.doi.org/10.1302/0301-620X.91B11.22658DOI Listing

Publication Analysis

Top Keywords

total knee
16
knee replacement
16
external tibial
16
tibial torsion
16
patellar instability
12
osteotomy osteoarthritis
8
osteoarthritis severe
8
severe external
8
tibial
6
patellar
5

Similar Publications

Background: Mismatch between osteochondral allograft (OCA) donor and recipient sex has been shown to negatively affect outcomes. This study accounts for additional donor variables and clinically relevant outcomes.

Purpose: To evaluate whether donor sex, age, donor-recipient sex mismatch, and duration of graft storage affect clinical outcomes and failure rates after knee OCA transplantation.

View Article and Find Full Text PDF

Background: Knee injuries resulting in purely cartilaginous defects are rare, and controversy remains regarding the reliability of chondral-only fixation.

Purpose: To systematically review the literature for fixation methods and outcomes after primary fixation of chondral-only defects within the knee.

Study Design: Systematic review; Level of evidence, 5.

View Article and Find Full Text PDF

Background: Many studies have examined the prevalence of acetabular version (AV) and femoral version (FV) abnormalities and their effect on patient-reported outcomes (PROs) after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), but few have explored the prevalence and influence of combined version (CV) abnormalities.

Purpose: To (1) describe the distribution of AV, FV, and CV in the largest cohort to date and (2) determine the relationship between AV, FV, and CV and PROs after hip arthroscopy for FAIS.

Study Design: Cohort study; Level of evidence, 3.

View Article and Find Full Text PDF

In modern knee arthroplasty, surgeons increasingly aim for individualised implant selection based on data-driven decisions to improve patient satisfaction rates. The identification of an implant design that optimally fits to a patient's native kinematic patterns and functional requirements could provide a basis towards subject-specific phenotyping. The goal of this study was to achieve a first step towards identifying easily accessible and intuitive features that allow for discrimination between implant designs based on kinematic data.

View Article and Find Full Text PDF

Background: Revision of a unicompartmental to a total knee arthroplasty (TKA) is often compared to primary TKA with regard to its technical difficulty and complication rates. We sought to compare medical and surgical complications following revision unicompartmental knee arthroplasty (UKA) to those following primary TKA and aseptic revision TKA.

Methods: A national administrative claims database was queried for patients undergoing revision UKA between 2010 and 2019.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!