title: Total Knee Arthroplasty in Patients with Blount Disease or Blount-Like Deformity.
abstract: Blount disease is associated with complex deformity of the proximal tibia, and some patients will develop knee osteoarthritis. Five patients (eight knees) with Blount disease or Blount-like deformity underwent total knee arthroplasty. Mean proximal tibial metaphyseal-diaphyseal angle was 20.75°. Each patient had substantial posteromedial tibial bony defects and six knees required extensive medial releases. Two knees required increased constraint at index procedure. One patient has undergone bilateral revision surgery with rotating hinge prostheses. Mean WOMAC scores were 13.5 and Knee Society scores were 212.5 at average 75.2 month follow-up. Despite technical challenges, patients with these deformities can have successful outcomes after total knee arthroplasty. Surgeons should be prepared to address posteromedial tibial bony defects and consider constrained arthroplasty at the index procedure.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Maguire Center, Loyola University Chicago, Maywood, Illinois.
authors.forename: Roman M
authors.initials: RM
authors.lastname: Natoli
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Maguire Center, Loyola University Chicago, Maywood, Illinois.
authors.forename: Chrissy M
authors.initials: CM
authors.lastname: Nypaver
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Maguire Center, Loyola University Chicago, Maywood, Illinois.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Schiff
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Maguire Center, Loyola University Chicago, Maywood, Illinois.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hopkinson
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Maguire Center, Loyola University Chicago, Maywood, Illinois.
authors.forename: Harold W
authors.initials: HW
authors.lastname: Rees
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001848:Bone Diseases, Developmental / Q000601:surgery* / Q000628:therapy; D018483:Diaphyses / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D007717:Knee / Q000033:anatomy & histology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D055034:Osteochondrosis / Q000151:congenital* / Q000601:surgery / Q000628:therapy; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
keywords: Blount disease; genu varum; gonarthrosis; osteoarthritis; total knee arthroplasty