Purpose: Severe extra-articular deformities can be treated with single-stage total knee replacement (TKA) and osteotomy. Aim of this study was to examine the patient-reported outcome measures (PROMs) and the complications after single-stage TKA and osteotomy. We hypothesized patients achieve good outcome after single-stage TKA and osteotomy, which is comparable to outcome after primary TKA without deformity.
Methods: Twenty-one patients with severe extra-articular deformity who underwent single-stage TKA and deformity-correcting osteotomy were reviewed and invited to fill in PROMs including the Oxford Knee Score, the Short Form-12, a Visual Analogue Scale for pain, and questions about satisfaction and quality of life.
Results: The mean follow-up period was 64 months. Ten patients were treated with TKA and supracondylar femoral osteotomy. Although PROMs showed good results (mean quality of life score was 85 out of 100), two patients had a revision of the osteotomy due to non-union. Eleven patients were treated with TKA and high tibial osteotomy. Patients were satisfied with the results (mean quality of life score was 81 out of 100). Two patients developed infection requiring debridement, resulting in one arthrodesis and one gastrocnemius transfer for wound closure.
Conclusion: In general, patients were satisfied with the postoperative result. Outcome was comparable to patients after primary TKA in the literature. However, serious complications need to be taken into account.
Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-015-3889-9 | DOI Listing |
J Orthop Surg Res
January 2025
Department of Orthopaedics, FuyangHospital of Anhui Medical University, Fuyang, Anhui, China.
Objective: This study aims to elucidate the impact of varying tourniquet application timings on postoperative pain and the bone cement interface following TKA.
Method: Patients who underwent TKA in our department between March 2021 and July 2023 were included in this study. They were randomly assigned to three groups: Group 1 used tourniquets throughout the operation, Group 2 applied tourniquets before the osteotomy, and Group 3 applied tourniquets after completing the osteotomy.
Purpose: Double-level osteotomies (DLOs) have shown promising results for knee joint preservation, however, most ultimately progress in terms of degenerative disease resulting in conversion to total knee arthroplasty (TKA). Therefore, the purpose of this study was to examine the time to TKA conversion, long-term clinical outcomes and revision rates of patients who have undergone TKA after prior ipsilateral DLO.
Methods: Patients who underwent simultaneous or staged DLO and subsequently underwent conversion to TKA at a single academic institution from 1997 to 2022 were evaluated.
J Orthop Case Rep
December 2024
Department of Orthopaedic and Trauma Surgery, Hospital General Universitario Gregorio Marañon, C. Dr. Esquerdo 46, 28007, Madrid, Spain.
Introduction: Extra-articular deformity is that located proximal to the femoral epicondyles or distal to the neck of the fibula. In patients with gonarthrosis associated with extra-articular deformity, a different evaluation and approach will be necessary at the time of planning the arthroplasty. 3D planning and printing techniques have had a major impact on pre-operative planning, allowing the production of custom guides at low cost and in an accessible way.
View Article and Find Full Text PDFJ Clin Med
November 2024
Radiological Diagnostics Center, The National Institute of Medicine of the Ministry of Interior and Administration, 02-507 Warsaw, Poland.
Lower-limb alignment deformities constitute a significant clinical concern, as they can lead to serious complications, including progressive degenerative diseases and disabilities. Rotational deformities may give rise to conditions such as joint arthrosis, patellar instability, and the degeneration of the patellofemoral cartilage. Therefore, a comprehensive evaluation of lower-limb alignment is essential for the effective patient management, preoperative planning, and successful correction of these deformities.
View Article and Find Full Text PDFBMC Musculoskelet Disord
November 2024
Center for Sports Medicine, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400036, China.
Purpose: The conversion of knee arthrodesis to total knee arthroplasty (TKA) is a challenging procedure. This article aims to report a case of fusion knee with patellar absence who was converted to TKA and has achieved good results.
Methods: The patient, a 23 years old Tibetan Buddhist monk, sustained a left knee joint injury at the age of 12 due to a car accident, leading to subsequent knee arthrodesis at 18 years old as a result of recurrent severe infections.
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