Relationship between Tibial Bone Defect and Extent of Medial Release in Total Knee Arthroplasty
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Purpose: To understand the relationship between tibial bone defect and extent of medial release in total knee arthroplasty. Materials and Methods: We evaluated 32 knees in 22 patients with variable degrees of tibial bone defect on medial plateau has undergone total knee arthroplasty. In this study, 31 cases had been diagnosed as degenerative osteoarthritis and 1 case was osteonecrosis. We excluded cases with infection, traumatic arthritis, or neuropathic joints. With regard to gender, 29 cases were female and 3 cases were male. The following relationships were analyzed: preoperative degrees of tibial bone defect and varus deformity; the femorotibial angle of both weight-bearing whole extremity radiogram, distractive stress radiogram, and the extent of medial release. Results: Average tibial bone defect was 9.8±4.1 mm. Average femorotibial angle on weight-bearing whole extremity radiograph was varus 10.0o±6.2o. Average femorotibial angle on distractive stress radiograph was varus 0.7o±4.6o. Statistically the extent of medial release showed no significant relationship with the degree of tibial bone defect and femoro-tibial angle of whole extremity radiogram. However, it revealed a statistically significant relationship with the femorotibial angle on distractive radiogram (r=0.465, p=0.007). Conclusions: Preoperative distractive stress radiograph might be a useful method to predict the extent of intraoperative medial release during total knee arthroplasty.
Abstract
Purpose: To understand the relationship between tibial bone defect and extent of medial release in total knee arthroplasty. Materials and Methods: We evaluated 32 knees in 22 patients with variable degrees of tibial bone defect on medial plateau has undergone total knee arthroplasty. In this study, 31 cases had been diagnosed as degenerative osteoarthritis and 1 case was osteonecrosis. We excluded cases with infection, traumatic arthritis, or neuropathic joints. With regard to gender, 29 cases were female and 3 cases were male. The following relationships were analyzed: preoperative degrees of tibial bone defect and varus deformity; the femorotibial angle of both weight-bearing whole extremity radiogram, distractive stress radiogram, and the extent of medial release. Results: Average tibial bone defect was 9.8±4.1 mm. Average femorotibial angle on weight-bearing whole extremity radiograph was varus 10.0o±6.2o. Average femorotibial angle on distractive stress radiograph was varus 0.7o±4.6o. Statistically the extent of medial release showed no significant relationship with the degree of tibial bone defect and femoro-tibial angle of whole extremity radiogram. However, it revealed a statistically significant relationship with the femorotibial angle on distractive radiogram (r=0.465, p=0.007). Conclusions: Preoperative distractive stress radiograph might be a useful method to predict the extent of intraoperative medial release during total knee arthroplasty.
참고문헌 (19)
- Mullaji AB, "Total knee arthroplasty for profound varus deformity: technique and radiological results in 173 knees with varus of more than 20degrees", J Arthroplasty, 20, pp.550~561 (2005)
- Clayton ML, "Correction of alignment deformities during total knee arthroplasties: staged soft-tissue releases", Clin Orthop Relat Res, 202, pp.117~124 (1986)
- Luring C, "The effectiveness of sequential medial soft tissue release on coronal alignment in total knee arthroplasty: using a computer navigation model", J Arthroplasty, 21, pp.428~434 (2006)
- Griffin FM, "Accuracy of soft tissue balancing in total knee arthroplasty", J Arthroplasty, 15, pp.970~973 (2000)
- Matsueda M, "Soft tissue release in total knee arthroplasty. Cadaver study using knees without deformities", Clin Orthop Relat Res, (366), pp.264~273 (1999)
- Yagishita K, "Step-by-step measurements of soft tissue balancing during total knee arthroplasty for patients with varus knees", J Arthroplasty, 18, pp.313~320 (2003)
- Insall JN, "Rationale of the Knee Society clinical rating system", Clin Orthop Relat Res, (248), pp.13~14 (1989)
- Ewald FC, "The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system", Clin Orthop Relat Res, (248), pp.9~12 (1989)
- Brand MG, "Tibial tray augmentation with modular metal wedges for tibial bone stock deficiency", Clin Orthop Relat Res, (248), pp.71~79 (1989)
- Sim JA, "Utility of preoperative distractive stress radiograph for beginners to extent of medial release in total knee arthroplasty", Clin Orthop Surg, 1, pp.110~113 (2009)
- Vail TP, "Surgical techniques and instrumentation in total knee arthroplasty, In Surgery of the knee. 4th ed", pp.1494~1521 (2006), Churchill Livingstone
- Peters CL, "Soft-tissue balancing in primary total knee arthroplasty", Instr Course Lect, 55, pp.413~417 (2006)
- Engh GA, "Medial epicondylar osteotomy: a technique used with primary and revision total knee arthroplasty to improve surgical exposure and correct varus deformity", Instr Course Lect, 48, pp.153~156 (1999)
- Abernethy PJ, "Fracture of the metal tibial tray after Kinematic total knee replacement. A common cause of early aseptic failure", J Bone Joint Surg Br, 78, pp.220~225 (1996)
- Bottros J, "Gap balancing in total knee arthroplasty", J Arthroplasty, 21, pp.11~15 (2006)
- Mihalko WM, "Flexion and extension gap balancing in revision total knee arthroplasty", Clin Orthop Relat Res, 446, pp.121~126 (2006)
- Freeman MA, "ICLH arthroplasty of the knee: 1968-1977", J Bone Joint Surg Br, 60, pp.339~344 (1978)
- Insall JN, "Total knee arthroplasty", Clin Orthop Relat Res, (192), pp.13~22 (1985)
- Bae DK, "Postoperative limb alignment after total knee arthroplasty depending on the severity of the varus knee", J Korean Knee Soc, 20, pp.137~142 (2008)