Use of theguide angle method using intramedullary guide angle for distal femoral cutting in total knee arthroplasty may cause error when rotation of the femur occurs or the insertion point of the intramedullary guide is incorrectly positioned in preoperative radiography. On the other hand, use of the measured cutting method, in which resection of distal femoral condyles is performed according to predicted measured thickness in a preoperative radiograph can allow for correction of these errors intraoperatively. Therefore, we compared these two distal femoral bone cutting methods for restoration of accurate coronal alignment. Between 2010 and 2012, 47 patients (70 knees) underwent total knee arthroplasty for treatment of osteoarthritis with varus deformity and flexion contracture less than 10 degrees. Bone resection depending on distal femur resection thickness measured before the operation was performed in 38 cases (Group I). Distal femoral cutting using the guide angle was performed in 32 cases (Group II). Radiographic evaluation, including mean value of lower leg mechanical axis angle and the frequency of errors of more than 3 degrees, was performed for comparison between the two groups.Purpose
Methods
Evaluation of status of collateral ligament & prediction of post-op alignment is important for partial knee replacement because during UKA the ligament can't be released & overcorrection or severe varus alignment result in poor clinical result. Evaluation of ligament could be done with valgus stress or distraction. The authors compare the stress view & distractive CT scanogram. to know the effectiveness regarding the prediction of final alignment. 19 knee from the 16 people receiving partial knee replacement was studied, we measure the anatomical axis &mechanical axis of the valgus stress view & distractive CT scanogram & post-operative whole leg radiogram.Purpose
Material & Method
The objective of this study was to compare the results between MCL complete detachment and medial epicondylar osteotomy for severe varus deformity in TKA. We reviewed 8 cases of MCL complete detachment (group I) and 11 cases of medial epicondylar osteotomy (group II) for severe varus deformity (from February 2001 to December 2006). In MCL complete detachment, we performed the reattachment of MCL and putting on the brace. Clinical outcome measures included Knee Society score (KSS), Function scrore (FS), and range of motion (ROM). Radiological outcomes were medial instability as determined by valgus stress radiograph, alignment by whole extremity radiograph. Group I had 4 neutral and 4 varus alignment and group II had 9 neutral, 1 varus and 1 valgus alignment. 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 (0.6–115° vs 0–118.8°). However, there were significant differences in medial instability compared normal side. Group I had the differences of 4.1 degree at postoperative 3 months and 2.1 degree at final follow-up. Group II had 0.9 degree at postoperative 3 months and 0.4 degree at final follow-up. Medial epicondylar osteotomy for severe varus deformity in TKA could be useful technique for medial stability of the knee regardless of the alignment.
