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Intra-articular correction of extra-articular tibial deformities with total knee arthroplasty
1Department of Orthopaedic Surgery, National University Hospital, Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
Introduction:
Extra-articular leg deformities may occur in the femur or tibia from mal-unions from previous trauma or metabolic bone disease. Secondary osteoarthritis at the knee occurs due to loss of mechanical alignment of the limb. At surgery for total knee arthroplasty, mechanical alignment can be restored intra-articularly with appropriate bone cuts and soft tissue balancing.
Presentation Of Case:
We describe 2 case studies with extra-articular tibial deformities (9° and 24° varus deformity) which were corrected with a 1 stage procedure of total knee arthroplasty with intra-articular deformity correction.
Discussion:
Patient selection, pre-operative considerations and surgical technique are discussed with reference to the literature.
Conclusion:
One stage intra-articular correction of extra-articular deformity is suitable for mild degrees of varus deformities (<30°). Staged corrective procedures with larger deformities in the tibia or femur can be performed with extra-articular osteotomies on top of intra-articular corrections. Consideration should be given to the use of computer navigation when conventional jigs cannot be applied to deformed bone.
