Abstract
During the ligament balancing for the severe medial contracture in varus knee TKA, complete distal release of the medial collateral ligament (MCL) or medial epicondylar osteotomy can be necessary in a large amount of correction. This study reviewed retrospectively 8 cases of complete distal release of the MCL (group 1) and 11 cases of medial epicondylar osteotomy (group 2) which was used to correct the severe medial contracture. In the complete distal release of the MCL, we performed the repair and used the brace for medial stability. The mean ages were 71.1-year-old and 71.5-year-old, respectively. The mean follow-up periods were 41.1 months and 21.9 months, respectively. Clinical outcome measures included Knee Society score (KSS), Function scrore (FS), and range of motion (ROM) at final follow up. Radiological outcomes measured medial instability by valgus stress radiograph at 3 months after operation and final follow up. There were no significant differences in clinical results between both two groups, for KSS (95.1 vs 91.1), FS (82.5 vs 88.2), and ROM (114.4Ëš vs 118.8Ëš). However, the medial instability of group 1 was larger than that of group 2 in the valgus stress radiograph (Figure 1). In terms of the medial stability, medial epicondylar osteotomy might be better than complete distal release of the MCL in varus TKA. Even though some some stability was obtained by MCL repair and bracing in complete distal release of the MCL, the medial instability was still remained. However, medial epicondylar osteotomy could give constant medial stability overall.
