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.
Methods: Fifty-one knees (39 patients) with a mechanical femoro-tibial angle (MFTA) greater than 15° treated with TKA was presented. The clinical and radiographic data were gathered prospectively. The patients were divided into two groups according to the preoperative angle: Group A comprised patients with a preoperative MFTA less than or equal to 20°, while Group B included patients with a preoperative MFTA greater than 20°.
Results: Among the 51 knees, 46 knees (90.2%) had femoro-tibial component size mismatch. The KSS-KS improved from preoperative 39.9 ± 11.3 points (range:18-68 points) to 92.3 ± 5.2 points (range: 83-100 points) at the final follow up (t = 30.141, P < 0.001); the KSS-FS improved from preoperative 48.0 ± 11.5 points (range: 31-71 points) to 87.2 ± 8.7 points (range: 63-100 points) at the final follow up (t = 19.413, P < 0.001). The mean MFTA was corrected from 21.0 ± 4.7° preoperatively to 2.9 ± 1.8° at the latest follow up (P < 0.001). The preoperative MFTA was less than or equal to 20° in 27 knees (Group A), and greater than 20° in 24 knees (Group B). The mean postoperative MFTA was 1.9 ± 0.9° in Group A, and 4.1 ± 1.7° in Group B (P < 0.001). The neutral limb alignment was reached in 26 knees (96.3%) in group A, which was significantly higher than that in group B (29.7%) (P = 0.019).
Conclusions: The technique of tibial plateau reduction provided satisfactory clinical and radiological outcomes without instability for severe varus TKA. However, surgeons should remain aware that the greater the preoperative varus deformity, the greater the postoperative residual varus deformity, and that there is a high incidence of femoro-tibial component size mismatch using the technique.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.knee.2024.12.005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Advanced Varus Deformity Associated with Medial Knee Osteoarthritis is a Potential Predictor of Anterior Cruciate Ligament Tear and Risk for Suitable Unicompartmental Knee Arthroplasty.
J Arthroplasty
January 2025
Department of Orthopedic Surgery, Nishinomiya Watanabe Hospital, Hyogo, Japan.
Background: Previous clinical studies suggest that preserving the anterior cruciate ligament (ACL) is crucial for stable knee motion and long-term longevity of the reconstructed knee. The ACL damage or loss often occurs in advanced medial osteoarthritis (OA). This study aimed to investigate the correlation between ACL damage and varus deformity progression as a risk factor for ACL tears in knee OA.
View Article and Find Full Text PDFManagement of Femoral Condyle Insufficiency Fractures Following Total Knee Arthroplasty (FCIF-TKA).
Cureus
December 2024
Orthopedic Surgery, Sengkang General Hospital, Singapore, SGP.
Background: Femoral condyle insufficiency fractures following total knee arthroplasty (FCIF-TKA) are rare but significant complications. These fractures, characterized by atraumatic bone insufficiency near the femoral component, present unique challenges in postoperative care, often necessitating femoral component revision.
Methods: This study retrospectively reviewed 835 primary total knee arthroplasties performed by a single surgeon, identifying six cases of FCIF-TKA.
How wide of a distal metaphyseal femoral fracture gap is a high risk of varus collapse and fixation failure? A finite element study.
Injury
December 2024
Golden Jubilee Medical Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Severe metaphyseal comminution and sizable bone defect of the distal femur are high risks of fixation failure. To date, no exact magnitude of comminution and bone loss is determined as an indication for augmentation of fixation construct. The present study aimed to investigate the influence of metaphyseal gap width, working length, and screw distribution on the stability of the fixation construct.
View Article and Find Full Text PDFPurpose Of The Study: Intraarticular fractures of the distal femur rank among the most severe musculoskeletal injuries. Various treatment options, such as plate osteosynthesis or retrograde nailing, can be employed. This study aims to evaluate the clinical outcomes and complications of intraarticular distal femoral fractures treated with retrograde femoral nail, with particular emphasis on C3 fractures.
View Article and Find Full Text PDFBiplanar Lateral Hemi-Wedge Osteotomy for the Correction of Severe Tibial Varus Deformity.
Arthrosc Tech
December 2024
Department for Orthopedics and Trauma Surgery, Martin Luther Hospital Berlin, Berlin, Germany.
Indication for this hemi-wedge high tibial osteotomy is the combination of medial osteoarthritis or cartilage damage, varus deformity of >10°, and medial proximal tibial angle of <80°. The proximal lateral tibia is exposed via a skin incision of approximately 10 cm length between the tibial tuberosity and the head of the fibula. After detachment of the anterior tibial muscle, a first oblique guidewire marks the main osteotomy plane and a second guidewire marks the hemi-wedge.
View Article and Find Full Text PDFWant 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!