Total knee arthroplasty in combination with a one-stage tibial osteotomy: a technique for correction of a gonarthrosis with a severe (>15 degrees) tibial extra-articular deformity.
Patients with a gonarthrosis and an extra-articular axis deformity >/=15 degrees (Krackow type VI) were treated by an unconstrained total knee arthroplasty combined with a tibial osteotomy. This technique was applied to 10 patients with a Krackow type VI deformity. The knee score improved significantly (P<.005, Wilcoxon test) from 28 +/- 15.25 (SD) preoperatively to 80.60 +/- 15.94 postoperatively, and the function score improved significantly (P<.017, Wilcoxon test) from 46.50 +/- 8.83 preoperatively to 76.00 +/- 21.19 postoperatively. The axis was corrected to an alignment of 5 degrees to 10 degrees in 8 patients and to 0 degrees to 4 degrees in 2 patients according to the Knee Society score. There were no patella-related problems and no nonunions. The advantages of this procedure are the preservation of the stable collateral ligaments, the avoidance of problems associated with managing bone deficiencies, and a precise axis correction compared with conventional techniques.
Radke
Stefan
S
Department of Orthopaedic Surgery, Julius-Maximilians-University, Wuerzburg, Germany. s-radke.klh@mail.uni-wuerzburg.de
Radke
Juergen
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016916:Joint Deformities, Acquired / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome