title: One-stage computer-assisted total knee arthroplasty and tibial osteotomy.
abstract: Same-stage tibial osteotomy may deserve consideration in candidates to total knee arthroplasty (TKA) who have severe bone deformities, particularly at extra-articular sites. This strategy obviates the need for either a major and technically difficult ligament release procedure, which may compromise ligament balancing, or the use of a semi-constrained prosthesis. This technical note describes a one-stage, computer-assisted technique consisting in TKA, followed by corrective tibial osteotomy to obtain an overall mechanical axis close to 180° without extensive ligament balancing. This technique provided satisfactory outcomes in 8 patients followed-up for at least 3years, with no specific complications or ligament instability and with a hip-knee-ankle angle close to 180°. After planning, intra-operative computer assistance ensures accurate determination of both implant position and the degree of correction achieved by the osteotomy.
authors.affiliation: Polyclinique du Val-de-Saône, 44, rue Ambroise-Paré, 71000 Macon, France.
authors.forename: S
authors.initials: S
authors.lastname: Denjean
authors.affiliation: Clinique Belledonne, pôle santé Axone, 75, avenue G.-Péri, 38400 Saint-Martin-d'Hères, France. Electronic address: dr.chatain.frederic@wanadoo.fr.
authors.forename: F
authors.initials: F
authors.lastname: Chatain
authors.affiliation: Clinique du Parc, 155 Ter, boulevard Stalingrad, 69006 Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Tayot
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000502:physiology; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001842:Bone and Bones; D005260:Female; D005500:Follow-Up Studies; D056304:Genu Valgum / Q000601:surgery; D056305:Genu Varum / Q000601:surgery; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
keywords: Computer-assisted surgery; High tibial osteotomy; Knee arthritis; Malunion; One-stage surgery; Severe extra-articular bone deformities; Total knee arthroplasty