title: Correction of alignment deformities during total knee arthroplasties: staged soft-tissue releases.
abstract: Preoperative evaluation consists of a series of radiographs and a careful analysis of the gait in order to estimate the amount of bone resection and soft-tissue release needed for successful arthroplasty. Graduated, surgical soft-tissue releases were used for realigning arthritic knees during arthroplasty. Medial, lateral, anterior, and posterior releases provide step-by-step correction for realigning markedly deformed joints. The procedure prevents "over-releasing" leading to ligamentous instability. At surgery the mechanical axis of the limb was used for knee realignment by use of a towel clip over the hip joint and palpation of the malleoli at the ankle; the center of the hip, knee, and ankle should be in a straight line. Elimination of abnormal moment (the tendency to produce motion about the normal axis) at the knee with weight-bearing was the goal for realignment. Proper alignment is the key to success and longevity in knee arthroplasty. Soft-tissue releases should be used with any type of instrumentation the surgeon desires. The patella must also be realigned.
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery; D005260:Female; D005684:Gait; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D009068:Movement; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D010347:Patient Care Planning; D011300:Preoperative Care; D011859:Radiography