Byron E Chalidis1, Ken Ye2, Nick P Sachinis2, Gabrielle Hawdon2, Stephen McMahon2. 1. Malabar Orthopaedic Clinic, 43 The Avenue, Windsor 3181, Melbourne, Australia. Electronic address: byronchalidis@gmail.com. 2. Malabar Orthopaedic Clinic, 43 The Avenue, Windsor 3181, Melbourne, Australia.
Abstract
BACKGROUND: The aim of this retrospective study was to evaluate the efficacy of a lateral parapatellar approach combined with a tibial tubercle osteotomy (TTO) in patients undergoing total knee arthroplasty (TKA) with non-correctable valgus knee osteoarthritis. METHODS: We studied 53 consecutive patients (57 knees) who had a primary TKA via lateral parapatellar approach with a global step-cut "coffin" type TTO over a 10-year period. All patients had non-correctable grade II valgus deformity according to the Ranawat classification. The average age of patients was 71 years (45 to 77) and the mean follow-up was 39 months (20 to 98). RESULTS: Post-surgery, there was a significant improvement in knee extension (p=0.002), flexion (p=0.006), Knee Society Pain and Function Scores (p<0.001) and WOMAC Osteoarthritis Index (p<0.001). The tibiofemoral angle changed from a preoperative median value of 11 deg (10 to 17) to a postoperative value of 3.75 deg (0 to 9). Congruent patellar tracking was observed in all cases. All but one osteotomy united in a median period of 16.7 weeks (9 to 28) and no hardware removal was required. One knee developed infection treated with two-stage reconstruction. A proximal tibial stress fracture also occurred in a patient on long-term bisphosphonate therapy. CONCLUSION: Lateral parapatellar approach along with TTO is an effective technique for addressing non-correctable valgus knee deformity during TKA.
BACKGROUND: The aim of this retrospective study was to evaluate the efficacy of a lateral parapatellar approach combined with a tibial tubercle osteotomy (TTO) in patients undergoing total knee arthroplasty (TKA) with non-correctable valgus knee osteoarthritis. METHODS: We studied 53 consecutive patients (57 knees) who had a primary TKA via lateral parapatellar approach with a global step-cut "coffin" type TTO over a 10-year period. All patients had non-correctable grade II valgus deformity according to the Ranawat classification. The average age of patients was 71 years (45 to 77) and the mean follow-up was 39 months (20 to 98). RESULTS: Post-surgery, there was a significant improvement in knee extension (p=0.002), flexion (p=0.006), Knee Society Pain and Function Scores (p<0.001) and WOMAC Osteoarthritis Index (p<0.001). The tibiofemoral angle changed from a preoperative median value of 11 deg (10 to 17) to a postoperative value of 3.75 deg (0 to 9). Congruent patellar tracking was observed in all cases. All but one osteotomy united in a median period of 16.7 weeks (9 to 28) and no hardware removal was required. One knee developed infection treated with two-stage reconstruction. A proximal tibial stress fracture also occurred in a patient on long-term bisphosphonate therapy. CONCLUSION: Lateral parapatellar approach along with TTO is an effective technique for addressing non-correctable valgus knee deformity during TKA.
Authors: José Roberto Tonelli Filho; Marcus Ceregatti Passarelli; João Alberto Salles Brito; Gustavo Constantino Campos; Alessandro Rozim Zorzi; João Batista de Miranda Journal: Rev Bras Ortop Date: 2016-10-25
Authors: Piotr Dudek; Dariusz Marczak; Tomasz Okoń; Dariusz Grzelecki; Jan Szneider; Jacek Kowalczewski Journal: J Clin Med Date: 2022-10-09 Impact factor: 4.964