Main Article Content
Objective: To demonstrate the varus correction angle after performing the medial tibial reduction osteotomy and tibia component undersizing and lateralization techniques for correcting varus deformity in computer-assisted and cruciate-retaining total knee arthroplasty.
Methods: Cadaveric study included 5 bodies (10 knee joints) using total knee arthroplasty surgery assessing the varus correction angle, degree, medial and lateral gap measurement of knee joint during the different angles. Then, medial tibial reduction osteotomy and tibia component undersizing and lateralization were performed by 3 and 6 mm and all parameters were measured.
Results: The varus correction angles after 3 and 6 mm medial tibial reduction osteotomy were 2.00 and 2.93 degrees respectively. The medial gap increased 1.5 mm after 3 mm medial tibial reduction osteotomy tibia component undersizing and lateralization in full extension knee position.
Conclusions: Medial tibial reduction osteotomy and tibia component undersizing and lateralization were used to correct the varus deformity in total knee arthroplasty. The average of the varus correction angle was only 0.6 degrees per 1 mm of bone cut, therefore, this technique should not recommend to be used alone for severe varus deformity knee.
Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 1987;30(8):914-8.
Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum 2008;58(1):26-35.
Lord J, Victor C, Littlejohns P, Ross F, Axford J. Economic evaluation of a primary care-based education programme for patients with osteoarthritis of the knee. Health technology assessment 1999;3(23):13-5.
Cooper C, Adachi JD, Bardin T, Berenbaum F, Flamion B, Jonsson H, et al. How to define responders in osteoarthritis. Curr Med Res Opin 2013;29(6):719-29.
Zhang W, Moskowitz R, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cartil 2008;16(2):137-62.
Van Manen MD, Nace J, Mont MA. Management of primary knee osteoarthritis and indications for total knee arthroplasty for general practitioners. J Am Osteopath Assoc 2012;112(11):709-15.
Tew M, Waugh W. Tibiofemoral alignment and the results of knee replacement. J Bone Joint Surg Br 1985;67(4):551-6.
Insall JN, Binazzi R, Soudry M, Mestriner LA. Total knee arthroplasty. Clin Orthop Relat Res 1985(192):13-22.
Krackow KA. The technique of total knee arthroplasty: CV Mosby Co; 1990.
Ritter MA, Davis KE, Davis P, Farris A, Malinzak RA, Berend ME, et al. Preoperative malalignment increases risk of failure after total knee arthroplasty. JBJS 2013;95(2):126-31.
Cho W-S, Byun S-E, Lee S-J, Yoon J. Laxity after complete release of the medial collateral ligament in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015;23(6):1816-23.
Tang Q, Yu H-c, Shang P, Tang S-k, Xu H-z, Liu H-x, et al. Selective medial soft tissue release combined with tibial reduction osteotomy in total knee arthroplasty. Journal of orthopaedic surgery and research 2017;12(1):1-7.
Ritter MA, Davis KE, Davis P, Farris A, Malinzak RA, Berend ME, et al. Preoperative Malalignment Increases Risk of Failure After Total Knee Arthroplasty. J Bone Joint Surg Am 2013;95(2).
Dixon MC, Parsch D, Brown RR, Scott RD. The correction of severe varus deformity in total knee arthroplasty by tibial component downsizing and resection of uncapped proximal medial bone. J Arthroplasty 2004;19(1):19-22.
Krackow KA, Raju S, Puttaswamy MK. Medial over-resection of the tibia in total knee arthroplasty for varus deformity using computer navigation. J Arthroplasty 2015;30(5):766-9.