Videshnandan Raut1, Hosam E Matar2, Amit Singh3. 1. Wrightington and Lancashire Teaching Hospitals, Edge Hill University, Wigan, WN6 9EP, UK. 2. Centre for Hip Surgery, Wrightington Hospital, Wigan, WN6 9EP, UK. hematar@doctors.org.uk. 3. Trauma and Orthopaedics, Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK.
Abstract
PURPOSE: To describe a surgical technique in correcting valgus deformity during total knee replacement and evaluate medium-term clinical outcomes. METHODS: This was a retrospective consecutive series of total knee replacement for severe valgus deformity of patients who underwent a lateral ligament complex release with a sliver osteotomy of the lateral femoral condyle with a minimum 1-year follow-up and recording objective and patient-reported outcome measures. RESULTS: Twenty-three patients (25 knees) were included with median follow-up of 5 years (range 1-15 years) and average age 67.7 years (range 43-87). The primary diagnosis was osteoarthritis in 14 patients (61%) and inflammatory arthritis in 9 patients (39%). At final follow-up, the median mechanical tibiofemoral angle was restored to 4° (range 2-7) compared with a median valgus of 20° (range 13-30) preoperatively. This was statistically significant (P < 0.00001). Median Oxford Knee Score at final follow-up was 43 (range 36-48) indicating satisfactory outcomes. There were no revisions for any cause with a mean arc range of movement 110° (range 85-120). CONCLUSION: This study shows that a technique utilising the familiar medial parapatellar approach, staged soft tissue releases, and a novel sliver lateral femoral condylar osteotomy with intact periosteum to release the lateral ligament complex leads to satisfactory medium-term outcomes, improved range of movement and patients' reported outcome measures. Sliver osteotomy is a useful technique in correcting valgus deformity in total knee replacements at medium-term follow-up. LEVEL OF EVIDENCE: IV.
PURPOSE: To describe a surgical technique in correcting valgus deformity during total knee replacement and evaluate medium-term clinical outcomes. METHODS: This was a retrospective consecutive series of total knee replacement for severe valgus deformity of patients who underwent a lateral ligament complex release with a sliver osteotomy of the lateral femoral condyle with a minimum 1-year follow-up and recording objective and patient-reported outcome measures. RESULTS: Twenty-three patients (25 knees) were included with median follow-up of 5 years (range 1-15 years) and average age 67.7 years (range 43-87). The primary diagnosis was osteoarthritis in 14 patients (61%) and inflammatory arthritis in 9 patients (39%). At final follow-up, the median mechanical tibiofemoral angle was restored to 4° (range 2-7) compared with a median valgus of 20° (range 13-30) preoperatively. This was statistically significant (P < 0.00001). Median Oxford Knee Score at final follow-up was 43 (range 36-48) indicating satisfactory outcomes. There were no revisions for any cause with a mean arc range of movement 110° (range 85-120). CONCLUSION: This study shows that a technique utilising the familiar medial parapatellar approach, staged soft tissue releases, and a novel sliver lateral femoral condylar osteotomy with intact periosteum to release the lateral ligament complex leads to satisfactory medium-term outcomes, improved range of movement and patients' reported outcome measures. Sliver osteotomy is a useful technique in correcting valgus deformity in total knee replacements at medium-term follow-up. LEVEL OF EVIDENCE: IV.
Entities:
Keywords:
Operative technique; Sliver sliding osteotomy; Total knee replacement; Valgus deformity