Extra-articular tibial deformity management in total knee replacement

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Extra-articular deformities in the femur or tibia present surgical challenges during knee replacement.
• Surgeons face a dilemma: correct the deformity pre-operatively or compensate during implant placement.

Purpose of the Study:

• To evaluate the efficacy of managing extra-articular tibial deformities during knee replacement without pre-operative correction.
• To assess clinical outcomes and mechanical axis correction in such cases.

Main Methods:

• Retrospective study of six patients undergoing knee replacement with pre-existing tibial deformities.
• Knee replacement performed without prior deformity correction.
• Evaluation of clinical outcomes, mechanical axis alignment, implant types, and computer guidance.

Main Results:

• Mean patient age was 66.5 years with a mean coronal plane tibial deformity of 8.6 degrees.
• Hip-knee-ankle angle improved from a mean of 12.6 degrees to 4 degrees.
• Mean Oxford knee score improved significantly from 19 to 33.6.

Conclusions:

• Planning tibial resection based on the mechanical axis of the tibia enables alignment correction without preoperative intervention.
• Pre-operative correction of extra-articular deformity may be unnecessary if tibial resection is less than 15 mm.