title: Comparison of complete distal release of the medial collateral ligament and medial epicondylar osteotomy during ligament balancing in varus knee total knee arthroplasty.
abstract: BACKGROUND
  During ligament balancing for severe medial contracture in varus knee total knee arthroplasty (TKA), complete distal release of the medial collateral ligament (MCL) or a medial epicondylar osteotomy can be necessary if a large amount of correction is needed.
  
  
  METHODS
  This study retrospectively reviewed 9 cases of complete distal release of the MCL and 11 cases of medial epicondylar osteotomy which were used to correct severe medial contracture. The mean follow-up periods were 46.5 months (range, 36 to 78 months) and 39.8 months (range, 32 to 65 months), respectively.
  
  
  RESULTS
  There were no significant differences in the clinical results between the two groups. However, the valgus stress radiograph revealed significant differences in medial instability. In complete distal release of the MCL, some stability was obtained by repair and bracing but the medial instability could not be removed completely.
  
  
  CONCLUSIONS
  Medial epicondylar osteotomy for a varus deformity in TKA could provide constant medial stability and be a useful ligament balancing technique.
authors: Department of Orthopedic Surgery, Gil Medical Center, Gachon University, Incheon, Korea.
authors: Jae Ang
authors: JA
authors: Sim
authors: Yong Seuk
authors: YS
authors: Lee
authors: Ji Hoon
authors: JH
authors: Kwak
authors: Sang Hoon
authors: SH
authors: Yang
authors: Kwang Hui
authors: KH
authors: Kim
authors: Beom Koo
authors: BK
authors: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008022:Ligaments; D008023:Ligaments, Articular / Q000503:physiopathology*; D017888:Medial Collateral Ligament, Knee / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Medial epicondylar osteotomy; Total knee arthroplasty; Varus knee