BackgroundPosterior stabilized (PS) total knee arthroplasty (TKA) is advocated in severe varus osteoarthritic (OA) knees as the posterior cruciate ligament posed challenges in gap balancing. However, there is scarcity in the literature to illustrate the superiority of PS TKA over cruciate retaining (CR) TKA. Our study aims to compare the outcomes between CR and PS TKAs in patients with severe varus OA knees. A retrospective review was conducted on patients who underwent primary TKA for OA knee from 2003 to 2013. Patients with OA knees of varus tibiofemoral angle ≥15 were matched into two groups (Group CR and PS) according to age, gender, and body mass index and compared in terms of clinical (tibiofemoral alignment, range of motion, and revision rate) and functional outcome (Knee Society Scoring, Oxford Knee Score, Short Form-36 Health Survey). Both Group CR ( = 56) and PS ( = 56) had similar pre-operative scores. Both groups achieved correction of tibiofemoral alignment from median pre-operative varus of 17.6/17.0 (CR/PS) ( = .279) to median post-operative valgus of 4.9/4.0 (CR/PS) ( = .408). Over 24 months, both groups were comparable in achieving significant improvement in clinical and functional outcomes. No case of revision surgery was reported (median follow-up months; CR: 65, PS: 74, = .549). Both CR and PS TKAs perform similarly well in severe varus OA knee up to 2 years post-operation. Further studies are warranted to assess the long-term outcome between the two implant designs.
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http://dx.doi.org/10.1177/23094990211055224 | DOI Listing |
Knee
December 2024
Department of Orthopaedic Surgery, The Affiliated Hospital of Xuzhou Medical University, Jiangsu, PR China.
Background: The optimal soft tissue release technique for severe varus total knee arthroplasty (TKA) remains controversial. The technique of tibial plateau reduction was suggested for severe varus deformity during TKA. The purpose of this study was to evaluate the clinical and radiological outcomes of the technique of tibial plateau reduction.
View Article and Find Full Text PDFClin Biomech (Bristol)
December 2024
Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA. Electronic address:
Background: Varus thrust is common in those with knee osteoarthritis. Varus thrust is traditionally identified with visual analysis or motion capture, methods that are either dichotomous or limited to the laboratory setting. Inertial measurement unit data has been found to correlate with motion capture measures of varus thrust in those with severe knee osteoarthritis, allowing for a quantitative and accessible way of measuring varus thrust.
View Article and Find Full Text PDFJ Clin Orthop Trauma
January 2025
St John of God Subiaco and Midland Hospitals, Subiaco, 6008, WA, Australia.
Introduction: Total knee arthroplasty (TKA) in severe varus deformity still remains a challenge. Alternative alignment TKA aims to improve outcomes and satisfaction. The purpose of this study is to report on the outcomes of a functionally aligned TKA in severe varus deformity.
View Article and Find Full Text PDFJ Bone Joint Surg Am
December 2024
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Background: Studies investigating constitutional alignment across various grades of osteoarthritis (OA) are limited. This study explored the distribution of Coronal Plane Alignment of the Knee (CPAK) types and associated radiographic parameters with increasing OA severity.
Methods: In this retrospective cross-sectional study, 17,365 knees were analyzed using deep learning software for radiographic measurements.
Orthop Traumatol Surg Res
December 2024
Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-Gu, Seoul, 06591, Republic of Korea. Electronic address:
Introduction: Although previous studies have shown that severe medial knee osteoarthritis (OA) (Kellgren-Lawrence grade IV) is a risk factor for patient dissatisfaction following medial open-wedge high tibial osteotomy (MOWHTO), it is uncommon to perform arthroplasty as a primary surgical option in patients 55 years of age or younger. Thus, the purpose of our study was to evaluate whether severe medial knee OA is a risk factor for dissatisfaction following MOWHTO depending on patient age based on a cutoff of 55 years.
Material And Methods: We retrospectively reviewed the data of 270 consecutive patients who underwent MOWHTO with a minimum of 2 years of follow up.
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