title: Computer-assisted total knee replacement in patients with arthritis and a recurvatum deformity.
abstract: We retrospectively reviewed the records of 1150 computer-assisted total knee replacements and analysed the clinical and radiological outcomes of 45 knees that had arthritis with a pre-operative recurvatum deformity. The mean pre-operative hyperextension deformity of 11° (6° to 15°), as measured by navigation at the start of the operation, improved to a mean flexion deformity of 3.1° (0° to 7°) post-operatively. A total of 41 knees (91%) were managed using inserts ≤ 12.5 mm thick, and none had mediolateral laxity > 2 mm from a mechanical axis of 0° at the end of the surgery. At a mean follow-up of 26.4 months (13 to 48) there was significant improvement in the mean Knee Society, Oxford knee and Western Ontario and McMaster Universities Osteoarthritis Index scores compared with the pre-operative values. The mean knee flexion improved from 105° (80° to 125°) pre-operatively to 131° (120° to 145°), and none of the limbs had recurrent recurvatum. These early results show that total knee replacement using computer navigation and an algorithmic approach for arthritic knees with a recurvatum deformity can give excellent radiological and functional outcomes without recurrent deformity.
authors.affiliation: Breach Candy Hospital, B Desai Road, Breach Candy, Mumbai 400026, India. arunmullaji@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Mullaji
authors.forename: A P
authors.initials: AP
authors.lastname: Lingaraju
authors.forename: G M
authors.initials: GM
authors.lastname: Shetty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012720:Severity of Illness Index; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome