Abstract
Safely obtaining adequate exposure is an integral step in successfully performing a Total Knee Arthroplasty. In this study, we look at approaching the valgus knee through a lateral arthrotomy and tibial tubercle osteotomy.
20 knees in 19 consecutive patients with valgus deformities are included in this study (2006 to 2010). LCS mobile bearing prostheses were implanted by a single senior surgeon (GF). Navigation was used for all the knees. The knee is approached throught a skin incision 5–10mm more lateral than the standard midline incision. The lateral arthrotomy is made to Gerdy's tubercle 7–10cm distal to Tibial Tendon insertion. 7cm long and 2cm wide osteotomy is performed. Richards staples are used to fix the osteotomy once the prosthesis is fixed. All patients were followed up by the operating surgeon.
All osteotomies united. 2 postoperative complications were encountered during follow up. One patient had a postoperative haematoma that was washed out. A second patient had a fall 6/52 post-op and sustained a minimally displaced fracture at the navigation pin site (Tibia). This was treated in a cylinder cast and went onto full union.
Our technique of lateral arthrotomy and TTO in the valgus knee is safe and predictable. It delivers wider exposure, facilitates soft tissue management, preserves viability of the extensor mechanism and allows some movement of the tibial tubercle for improved patella tracking. We recommend planning this procedure preoperatively for best results.
