Extra-articular deformity is always correctable intra-articularly: in the affirmative

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering

Background:

• Total knee replacement (TKR) presents challenges in patients with coexisting knee arthritis and extra-articular deformities.
• Restoring the mechanical axis is difficult, complicating standard TKR procedures.

Observation:

• Severe extra-articular knee deformities (e.g., >20 degrees varus/valgus, recurvatum, fracture malunion) require specialized TKR techniques.
• A one-stage TKR with intra-articular correction of extra-articular deformity was chosen as the preferred method.

Findings:

• Two patients with severe deformities underwent successful one-stage TKR with intra-articular correction.
• The procedure, previously successful in 15 cases, resulted in no complications and significant functional improvement (Knee Society Scores improved from 40 to 95).
• No instability was observed at the 2-year follow-up.

Implications:

• One-stage TKR with intra-articular correction is a viable and effective treatment for complex knee arthritis with extra-articular deformities.
• Careful surgical planning, precise bone cuts, and soft tissue balancing are crucial for successful outcomes.
• This approach offers a promising solution for improving patient function and stability in challenging cases.