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Correcting varus deformity.

Arun Mullaji1, Satyajit Marawar, Amit Sharma

  • 1Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India.

The Journal of Arthroplasty
|August 25, 2007
PubMed
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This study details a surgical technique for severe knee varus deformity, achieving excellent alignment and stability using posterior stabilized implants. The method successfully corrected deformities and improved patient function without requiring constrained implants.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Severe intra- and extra-articular varus deformity presents significant challenges in knee joint treatment.
  • Traditional methods may require constrained implants, potentially limiting outcomes.

Purpose of the Study:

  • To present a surgical technique utilizing posterior stabilized fixed-bearing implants for severe varus knee deformities.
  • To evaluate the efficacy of selective posteromedial release and reduction osteotomy in correcting these deformities.

Main Methods:

  • The study involved 173 knees in 117 patients undergoing treatment for severe varus deformity.
  • A technique combining selective posteromedial release and reduction osteotomy of the posteromedial tibial flare was employed.
  • Proximal tibial osteotomy was utilized for correcting extra-articular deformities.

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Main Results:

  • Preoperative mean tibiofemoral varus of 22 degrees was corrected to a postoperative mean of 5.3 degrees valgus.
  • 86% of knees achieved a postoperative valgus alignment between 4 and 10 degrees.
  • Significant improvements were observed in Knee Society scores (22.8 to 91.1) and function scores (22.8 to 72.1) over a 2-9 year follow-up.
  • Bone graft incorporation was successful in 28 out of 30 tibial defects.
  • No significant instability was reported, and only three knees experienced tibial component loosening.

Conclusions:

  • The described surgical technique effectively restores alignment and stability in severe varus knee deformities.
  • Posterior stabilized fixed-bearing implants can be used successfully without the need for constrained implants.
  • The technique offers a viable solution for complex knee deformities, leading to improved patient outcomes.