Long-Term Results of Total Knee Arthroplasty for Valgus Knees: Soft-Tissue Release Technique and Implant Selection

Rajgopal, Ashok; Dahiya, Vivek; Vasdev, Attique; Kochhar, Hemanshu; Tyagi, Vipin

doi:10.1177/230949901101900114

Cited by 35 publications

(28 citation statements)

References 12 publications

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“…7 In the study of Lu et al, out of 74 patients 63 were women and 11 were men with mean age of 62.93 years. 8 Both observations in our study, mean age and female preponderance, were found to be consistent with Elkus et al study and Lu study.…”

Section: Incidence With Age and Sexsupporting

confidence: 93%

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To study surgical outcome of various surgical procedures of lateral release in valgus knee in total knee arthroplasty

Patel

Shah

et al. 2017

Int J Res Orthop

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Background: Fixed valgus deformity presents a major challenge in total knee arthroplasty (TKA), especially in moderate or severe cases. In knee arthritis, fixed-varus deformity (50 to 55%) is three times more frequent than fixed-valgus deformity (10 to 15%). Valgus deformity occurs more commonly in rheumatoid arthritis and also in osteoarthritis with hypoplasia of the lateral femoral condyle. Valgus deformity is often associated with flexion or external rotation contracture of the knee. In this study we aim to study the surgical outcome of total knee replacement in valgus deformity via standard medial parapatellar approach using various techniques like Pie –Crusting release of lateral structures or combined technique of pie crusting and standard release of lateral structures. Aim: To evaluate surgical outcome of various surgical techniques via standard medial parapatellar approach in fixed valgus deformity in Total Knee Arthroplasty.Methods: The present study involved both male and female patients with osteoarthritis of knee with valgus deformity. In present series, 26 consecutive patients of osteoarthritis with valgus deformity operated with total knee replacement were included. Previously operated cases of high tibial osteotomy and patients having contraindication for TKA were excluded from the study.Results: Valgus angle in this study was between 13 to 27 degree with average 17.84 degree. These results were comparable to many such similar studies. In our study, post operatively, knee society score was average 87.69 and function knee score was 82.5. Mean range of motion was 105 degree. In our study, mean tibiofemoral alignment improved from 17.84 valgus to 4.7 valgus.Conclusions: Knee society score is excellent with both techniques and there is no difference in both techniques Iliotibial band and posterolateral capsule are most common structures that require release. Initial ligament balancing should be done with pie crusting and then sequential lateral release if require.

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Section: Incidence With Age and Sexsupporting

confidence: 93%

“…8 All knees had a good patellar position and were clinically stable in both mediolateral and anteroposterior planes. No radiolucency was noted.…”

Section: Valgus Anglementioning

confidence: 90%

To study surgical outcome of various surgical procedures of lateral release in valgus knee in total knee arthroplasty

Patel

Shah

et al. 2017

Int J Res Orthop

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“…In the knees with valgus deformity, release of the iliotibial band was performed via pie-crusting with a needle [6,7,44]. If required, additional release of the lateral collateral ligament, popliteus tendon and posterolateral capsule was carried out with great care, as there is a risk of posterolateral flexion gap instability, which necessitates the use of a constrained condylar prosthesis design [12,27,43,56]. Ligament balancing was performed with the trial implants in place.…”

Section: Surgical Techniquementioning

confidence: 99%

Total knee arthroplasty in patients with substantial deformities using primary knee components

Muylder

Victor

Kaminski

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…There is evidence that surgery in patients with a worse condition is less likely to be successful, particularly with valgus deformity progressing beyond 25° 33. It is important to monitor all patients attending such clinics specifically for valgus deformity and for overall function for example with the Oxford Knee Score 34…”

Section: Discussionmentioning

confidence: 99%

Group Acupuncture for Knee Pain: Evaluation of a Cost-Saving Initiative in the Health Service

White

Richardson²,

Richmond³

et al. 2012

Acupunct Med

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BackgroundAcupuncture has been provided in nurse-led group clinics in St Albans since 2008. It is funded by a commissioning group within the National Health Service, on a trial basis, for patients with knee osteoarthritis who would otherwise be referred to an orthopaedic surgeon.AimTo evaluate the patients seen in the service's first year of operation and their outcome up to the end of 2010.MethodsService evaluation was made of patient data from the referral centre and the acupuncture clinics, including baseline characteristics, attendance data and Measure Yourself Medical Outcome Profile (MYMOP) symptom, function and well-being scores over at least 2 years.Results114 patients were offered acupuncture, of whom 90 patients were assessed in the acupuncture clinics. 41 of these were still attending after 1 year and 31 (34%) after 2 years. MYMOP scores showed clinically significant improvements at 1 month for pain (4.2 (SD 1.2) to 2.9 (SD 1.4)), stiffness (4.1 (SD 1.3) to 2.9 (SD 1.3)) and function (4.5 (SD 1.1) to 3.3 (SD 1.2)) which continued up to 2 years. Well-being scores did not change.ConclusionsThis is the first evaluation of nurse-led group (multibed) acupuncture clinics for patients with knee osteoarthritis to include a 2 year follow-up. It shows the practicability of offering a low-cost acupuncture service as an alternative to knee surgery and the service's success in providing long-term symptom relief in about a third of patients. Using realistic assumptions, the cost consequences for the local commissioning group are an estimated saving of £100 000 a year. Sensitivity analyses are presented using different assumptions.

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Long-Term Results of Total Knee Arthroplasty for Valgus Knees: Soft-Tissue Release Technique and Implant Selection

Cited by 35 publications

References 12 publications

To study surgical outcome of various surgical procedures of lateral release in valgus knee in total knee arthroplasty

To study surgical outcome of various surgical procedures of lateral release in valgus knee in total knee arthroplasty

Total knee arthroplasty in patients with substantial deformities using primary knee components

Group Acupuncture for Knee Pain: Evaluation of a Cost-Saving Initiative in the Health Service

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