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Exposure in difficult total knee arthroplasty using tibial tubercle osteotomy
1Biomechanical Research Laboratory, Missouri Bone and Joint Center, St Louis 63141, USA.
Clinical Orthopaedics and Related Research
|December 1, 1995
Summary
Extended tibial tubercle osteotomy provides adequate exposure for total knee arthroplasty, avoiding quadriceps release. This technique demonstrated good range of motion with minimal complications in 136 cases.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
Background:
- Achieving adequate exposure during total knee arthroplasty (TKA) can be challenging.
- Tibial tubercle osteotomy is a technique to improve exposure, but its outcomes require evaluation.
Purpose of the Study:
- To assess the efficacy and complications of extended tibial tubercle and tibial crest osteotomy in TKA.
- To evaluate the necessity of quadriceps mechanism release with this exposure technique.
Main Methods:
- A retrospective review of 136 TKAs performed between 1986 and 1994 using extended tibial tubercle and tibial crest osteotomy.
- Analysis of primary, revision, and infected cases, including fixation with wires and functional outcomes.
Main Results:
- Adequate exposure was consistently achieved without necessitating further quadriceps mechanism release.
- Mean range of motion at 2 years was 93.7 degrees; complications included minor avulsion fractures and wire removal for pain.
- No non-unions were observed, even in infected cases requiring repeat elevation of the osteotomy flap.
Conclusions:
- Extended tibial tubercle and tibial crest osteotomy is an effective method for achieving exposure in TKA.
- This technique minimizes the need for quadriceps manipulation, with a low complication rate.