Results of Posteromedial Capsule and Superficial Medial Collateral Ligament Release on Gap and Alignment in Total Knee Arthroplasty for Varus Knee Deformity by Computer-Assisted Surgery Measurement
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Abstract
Objective: Soft tissue release and gap balancing in varus knee deformity following total knee arthroplasty (TKA) are important issues that lack conclusive results. Various techniques including posteromedial capsule (PMC) and superficial medial collateral ligament (sMCL) release have been used for varus knee correction and flexion gap balance.
Methods: We retrospectively reviewed data from patients who had undergone TKA with computer-assisted surgery measurement and the use of PMC and sMCL release by the preservation of anterior attachment of pes anserine at our institute from November 2015 to February 2016. Gaps and alignment were measured and recorded by computer-assisted surgery measurement.
Results: Twenty-one patients were enrolled. The mean age was 68.0 (48.0-78.0) years with a mean preoperative hip-knee-ankle angle of 8.1 (3.5-16.0) degrees and a mean flexion contracture (FC) of 11.3 (3.5-16.0) degrees. The mean corrections for varus deformity after PMC and sMCL release were 4.9 ± 2.8 and 3.4 ± 1.7 degrees, respectively, with the mean FC after PMC and sMCL release correction of 5.6 ± 3.5 and 1.3 ± 2.9 degrees. The mean medial extension gap changes after PMC and sMCL release were 1.8 ± 1.4 and 1.7 ± 1.0 millimetres, respectively, with mean medial flexion gap after PMC and sMCL release changes of 0.7 ± 0.9 and 5.1 ± 2.1 millimetres, respectively. There was no significant change in lateral gaps after PMC and sMCL release. No instability of the knee was found.
Conclusion: The sMCL released with the preservation of the anterior attachment of pes anserinus in total knee arthroplasty has an additional effect on varus knee correction and flexion gap balance after PMC release without the creation of knee instability.
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