title: Effects of Reduction Osteotomy on Gap Balancing During Total Knee Arthroplasty for Severe Varus Deformity.
abstract: This study aimed to assess the effects of down-sizing and lateralizing of the tibial component (reduction osteotomy) on gap balancing in TKA, and the clinical feasibility of an uncemented modular trabecular metal tibial tray in this technique. Reduction osteotomy was performed for 39 knees of 36 patients with knee OA with a mean tibiofemoral angle of 21° varus. In 20 knees, appropriate gap balance was achieved by release of the deep medial collateral ligament alone. Flexion gap imbalance could be reduced by approximately 1.7° and 2.8° for 4-mm osteotomy and 8-mm osteotomy, respectively. Within the first postoperative year, clinically-stable tibial component subsidence was observed in 9 knees, but it was not progressive, and the clinical results were excellent at a mean follow-up of 3.3 years.
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Niki
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Harato
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Suda
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D017885:Collateral Ligaments / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D010351:Patient Discharge; D011184:Postoperative Period; D016059:Range of Motion, Articular; D013977:Tibia / Q000601:surgery*
keywords: component subsidence; gap balancing; reduction osteotomy; total knee arthroplasty; trabecular metal