Total knee arthroplasty in severe valgus knee deformity: comparison of a standard medial parapatellar approach combined with tibial tubercle osteotomy

Purpose Primary TKA in valgus knees with a deformity of more than ten degrees may prove challenging, since bone and soft tissue abnormalities make accurate axis restoration, component orientation and joint stability attainment a difficult task. The purpose of this study was to determine which approa...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2011-11, Vol.19 (11), p.1834-1842
Main Authors: Nikolopoulos, D. D., Polyzois, I., Apostolopoulos, A. P., Rossas, C., Moutsios-Rentzos, A., Michos, I. V.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee - methods
Bones
Evaluation
Female
Humans
Joint Capsule - surgery
Joint Deformities, Acquired - surgery
Joint replacement surgery
Knee
Knee Joint - surgery
Knees
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Osteotomy - methods
Patella - surgery
Patients
Reoperation
scoring
Sports
Statistics, Nonparametric
Surgery
Tibia - surgery
Transplants & implants
Treatment Outcome
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Summary:Purpose Primary TKA in valgus knees with a deformity of more than ten degrees may prove challenging, since bone and soft tissue abnormalities make accurate axis restoration, component orientation and joint stability attainment a difficult task. The purpose of this study was to determine which approach is optimal in these patients, by comparing the standard medial parapatellar approach to a lateral parapatellar combined with a tibial tubercle osteotomy (TTO). Methods Forty-four valgus knees—with an axis deviation ranging from 15 to 36 degrees (mean 24°)—were dealt with primary TKA and followed up for a minimum period of 7 years. Lateral parapatellar arthrotomy combined with TTO was performed in 22 individuals (Group A) and a standard medial parapatellar capsulotomy in the remaining patients (Group B). The International Knee Society System Score (IKSS) was used for clinical evaluation. Radiological assessment was performed yearly postoperatively using long films for assessment of the anatomical axis. Results The postoperative IKSS scores showed no significant statistical difference between groups A and B ( P  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-011-1474-4