Clinical Faceoff: Do We Need Special Strategies for Asian Patients with TKA?

Kim, Young Hoo; Matsuda, Shuichi; Kim, Tae Kyun

doi:10.1007/s11999-016-4716-4

Cited by 13 publications

(9 citation statements)

References 29 publications

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“…Many articles reported that the characteristics of the anatomical variations in Asia were lateral and anterior bowing of the femoral shaft, the proximal tibia vara with the medial shift of the TAS, and the medial torsion of the tibia. 4 –6,8,9,12…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] It has been reported that the proximal tibia vara involved the medial shift of the tibial articular surface (TAS). 4,[6][7][8] However, it is still obscure that the varus inclination of the TAS has a correlation with the medial shift of the TAS. The constitutional varus knee could be the consequence based on Hueter-Volkmann's law, which states that growth at the epiphyses is retarded by increased compression, whereas reduced loading accelerates growth.…”

Section: Introductionmentioning

confidence: 99%

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Proximal tibia vara involves the medial shift of the tibial articular surface

Kawasaki

Nagamine

Chen

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: According to the concept of the constitutional varus, the tibial articular surface (TAS) has varus inclination. On the other hand, it has been reported that proximal tibia vara involved medial shift of the TAS. However, it has not been assessed whether varus inclination of the TAS has a correlation with the medial shift. We investigated whether varus inclination of the TAS has a correlation with the medial shift. If there is a correlation between two parameters, the influence of the medial shift of the TAS on the value of the hip–knee–ankle (HKA) angle and the femorotibial angle should be considered. Methods: A total of 112 patients who underwent total knee arthroplasty had anteroposterior view tibia digital radiograph on which five parameters were analyzed. Varus angle of the TAS, the distance between the mechanical axis and the anatomical axis on the articular surface, and the width of the articular surface were measured. Results: The more the proximal tibia had varus deformity, the more the TAS shift medially would be. Therefore, the mechanical axis does not match the anatomical axis. Because the HKA angle was assessed based on the concept that the mechanical and anatomical axes match on the tibia, this angle may not express the true alignment of the lower extremity in knees with proximal tibia vara. Conclusion: In varus knees, the proximal tibia has a medial shift of the TAS that may influence the value of the HKA angle.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proximal tibia vara involves the medial shift of the tibial articular surface

Kawasaki

Nagamine

Chen

et al. 2020

J Orthop Surg (Hong Kong)

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“…(2) Decide what modifications should be made in postoperative rehabilitation protocols to accommodate the unexpected events during surgery. For example, vigorous medial ligament release, which is often required in TKA for Asian knees with severe varus deformity, sometimes end up with complete release of superficial MCL, subsequently causing medial instability [5,7]. This type of medial instability originating from complete release of superficial MCL, arguably can be treated by surgical repair without using constrained types of prostheses [9] or even bracing without additional surgical remedy [6].…”

Section: Unexpected Adverse Events During Surgery-guiding Principlesmentioning

confidence: 99%

CORR ® International—Asia-Pacific: How To Live a Happy Life as an Orthopaedic Surgeon

Kim

2017

Clinical Orthopaedics &Amp; Related Research

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“…Disease or symptom patterns vary within each region. For example, the presence of varus deformity, which is much more frequent in the Asia-Pacific region than in other regions [8,10,11], is an important factor to consider when identifying the underlying causes for symptoms or conditions [2], or predicting disease progression and making treatment plans [7,15].…”

Section: Algorithmic Approach In Clinicmentioning

confidence: 99%

Clinical Faceoff: Do We Need Special Strategies for Asian Patients with TKA?

Cited by 13 publications

References 29 publications

Proximal tibia vara involves the medial shift of the tibial articular surface

Proximal tibia vara involves the medial shift of the tibial articular surface

CORR ® International—Asia-Pacific: How To Live a Happy Life as an Orthopaedic Surgeon

CORR ® International—Asia-Pacific: 100 Patients a Day: Teaching Our Rising Stars How to Be Both Busy and Excellent

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