Same-stage total knee arthroplasty and osteotomy for osteoarthritis with extra-articular deformity. Part I: Tibial osteotomy, prospective study of 26 cases

Catonné, Yves; Sariali, Elhadi; Khiami, F.; Rouvillain, J.-L.; Wajsfisz, Antony; Pascal‐Moussellard, Hugues

doi:10.1016/j.otsr.2019.04.010

Cited by 17 publications

(13 citation statements)

References 10 publications

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“…But in severe extra-articular tibia vara, correction by intra-articular bone cutting requires extensive resection on the lateral side, which may induce laxity. 23 A postoperative HKA that deviates more than 3 from neutral correlates with worse functional outcome and prosthesis survival. 24 Saibaba et al 6 have reported that extraarticular tibia vara measured by MDA is associated with abnormal postoperative HKA (beyond 180 + 3 ) when MDA is above 4 with a sensitivity of 78.1%, specificity of 62.5%, and p value of 0.03.…”

Section: Discussionmentioning

confidence: 97%

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Postoperative radiologic outcome comparison between conventional and computer-assisted navigation total knee arthroplasty in extra-articular tibia vara

Cho

Shin

Kim

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: Total knee arthroplasty (TKA) is the definite treatment for osteoarthritis. Meanwhile, significant inherent extra-articular varus angulation is associated with abnormal postoperative hip–knee–ankle (HKA) angle. Computer-assisted navigation TKA (CAS-TKA) used in patients who have severe varus deformity. The purpose of this study was to compare postoperative radiologic outcome between CAS-TKA and conventional TKA for extra-articular tibia vara. Methods: A retrospective review of postoperative HKA on standing lower extremity views was conducted in patients who underwent TKA by a single surgeon from 2010 to 2018, including knee with conventional TKA ( n = 83) and CAS-TKA ( n = 246). Extra-articular tibia vara was assessed by measuring the metaphyseal–diaphyseal angle (MDA) of the tibia in preoperative standing lower extremity view. Postoperative alignment was assessed by measuring the HKA in postoperative standing lower extremity view. Results: There was no significant difference in age ( p = 0.063), gender ( p = 0.628), body mass index ( p = 0.426), preoperative range of motion ( p = 0.524), preoperative HKA ( p = 0.306), preoperative MDA ( p = 0.523), or postoperative HKA ( p = 0.416) between the two groups (conventional TKA and CAS-TKA). There was no significant difference in postoperative alignment for cases with MDA ≤4° ( p = 0.351) or MDA >4° ( p = 0.866) in each group. There was a positive correlation between preoperative HKA and postoperative HKA in the CAS-TKA group ( p < 0.001, r = 0.243). However, there was no significant correlation between preoperative HKA and postoperative HKA in the conventional TKA group ( p = 0.732). Conclusions: There was no significant difference in postoperative alignment between conventional TKA and CAS-TKA in extra-articular tibial vara even for cases with MDA >4°.

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Section: Discussionmentioning

confidence: 97%

“…But in severe extra-articular tibia vara, correction by intra-articular bone cutting requires extensive resection on the lateral side, which may induce laxity. 23…”

Section: Discussionmentioning

confidence: 99%

Postoperative radiologic outcome comparison between conventional and computer-assisted navigation total knee arthroplasty in extra-articular tibia vara

Cho

Shin

Kim

et al. 2020

J Orthop Surg (Hong Kong)

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“…Catonnea (10) reported on 26 knee replacements in 25 patients where an extra-articular deformity was corrected through an osteotomy at the time of knee replacement. Limited information is available regarding planning.…”

Section: Discussionmentioning

confidence: 99%

Extra-articular tibial deformity management in total knee replacement

Agarwal¹,

Choi²,

Kumar³

et al. 2021

Acta Orthop Belg

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Background : Presence of an extra-articular deformity in the femur or tibia poses a challenge to the surgeon undertaking knee replacement procedure. The conundrum is whether to correct the deformity beforehand, or accept the deformity and compensate for this through placement of the implant. Material and Methods : This is a retro-spective study comprising six patients who had a knee replacement in the presence of an extra-articular deformity of the tibia treated at our centre. All six had the knee replacement without correction of deformity. The data evaluated included clinical outcome, mechanical axis correction, type of implant, and the use of any software / computer guidance. The deformity was managed through planning of tibial resection without the need for pre-operative deformity correction. Results : Mean age was 66.5 years. Mean coronal plane deformity in the tibia was 8.6 degrees. The hip- knee-ankle improved from a mean 12.6 degrees to 4 degrees. Mean Oxford knee score improved from a mean of 19 to 33.6. Conclusion : Planning the tibial resection on the basis of mechanical axis of tibia allows correction of alignment without the need for preoperative correction. Correction of the deformity may not be needed if the maximum tibial resection is less than 15 mm.

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“…Bony correction can be staged prior to TKA surgery or simultaneously as a 1-stage procedure. 1-stage procedures are well described in cases with tibial deformity (Wang and Wang 2002, Xiao-Gang et al 2012, Catonné et al 2019) and have also been described for proximal tibial non-union (Moskal andMann 2001, Papagelopoulos et al 2007).…”

Section: Surgical Planning and Techniquementioning

confidence: 99%

“… 2012 , Catonné et al. 2019 ) and have also been described for proximal tibial non-union (Moskal and Mann 2001 , Papagelopoulos et al. 2007 ).…”

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confidence: 96%

1-stage total knee arthroplasty and proximal tibial non-union correction using 3-D planning and custom-made cutting guide

2021

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Same-stage total knee arthroplasty and osteotomy for osteoarthritis with extra-articular deformity. Part I: Tibial osteotomy, prospective study of 26 cases

Cited by 17 publications

References 10 publications

Postoperative radiologic outcome comparison between conventional and computer-assisted navigation total knee arthroplasty in extra-articular tibia vara

Postoperative radiologic outcome comparison between conventional and computer-assisted navigation total knee arthroplasty in extra-articular tibia vara

Extra-articular tibial deformity management in total knee replacement

1-stage total knee arthroplasty and proximal tibial non-union correction using 3-D planning and custom-made cutting guide

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