title: Simultaneous femoral and tibial osteotomies during total knee arthroplasty for severe extra-articular deformity.
abstract: Total knee arthroplasty (TKA) performed in knees with mild or moderate intraarticular deformity often can be resolved with careful ligament balancing and bone resection. However, extra-articular deformity may require an osteotomy to safely create rectangular flexion and extension gap balance. In these challenging situations, restoring the mechanical axis through intra-articular bone resection and soft tissue releases alone can lead to excessive bone loss and ligament instability. We report a case of TKA with combined femoral and tibial osteotomies in a post-polio patient with extra-articular deformities. Although a few small case studies have been previously published in the literature, specific details regarding this procedure are lacking. Our objective is to provide a detailed surgical technique and to review the indications for extra-articular osteotomies performed during TKA.
authors.affiliation: Department of Orthopedics, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Moyad
authors.forename: Daniel
authors.initials: D
authors.lastname: Estok
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D005269:Femur / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011051:Poliomyelitis / Q000150:complications; D013977:Tibia / Q000473:pathology / Q000601:surgery*