Total knee arthroplasty associated with tibial tubercle and simultaneous femoral and tibial osteotomies for severe extra-articular deformity: a case report

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11150%2F19%3A10398526" target="_blank" >RIV/00216208:11150/19:10398526 - isvavai.cz</a>

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=WxzyejxSbl" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=WxzyejxSbl</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.2147/TCRM.S193888" target="_blank" >10.2147/TCRM.S193888</a>

Result language

angličtina

Original language name

Total knee arthroplasty associated with tibial tubercle and simultaneous femoral and tibial osteotomies for severe extra-articular deformity: a case report

Original language description

The restoration of the lower extremity mechanical axis in patients with osteoarthritis in knee and extra-articular deformity requires careful pre-operative planning. An extra-articular deformity may be corrected inside the knee by arthroplasty with intra-articular correction or outside of the knee by osteotomy alone or by arthroplasty combined with extra-articular corrective osteotomy. In this study, we described a unique case of simultaneous femoral and tibial osteotomies at the time of primary total knee arthroplasty in a 45-year-old woman. To prevent unnecessary bone loss, the intra-articular bone resections were made parallelly to the preexisting joint obliquity prior to the corrective tibial and femoral osteotomies. After restoration of the mechanical axis and healing of all osteotomies, a successful clinical and radiological outcome was achieved during the mid-term 5-year follow-up. The preoperative analysis of patients with an extra-articular deformity is invaluable and should include long-standing radiographs from the center of the femoral head to the center of the ankle. Although different osteotomy principles (opening wedge vs closing wedge) and fixation methods (stemmed revision prosthesis, intramedullary nail, locking plates) have been reported in the literature, the use of a tapered fluted long stem offers several benefits, including ease of application, rotational control, and possible early weight bearing. Total knee arthroplasty in combination with simultaneous extra-articular osteotomy is technically difficult but effective. This technique helps to preserve bone stock and ligament stability. A single intervention leads to less recovery time, reduced risk to the patients by avoiding two separate applications of anesthesia, and reduced costs. Based on the literature search, this is the first report describing the detailed surgical technique of simultaneous femoral and tibial osteotomies at the time of primary total knee arthroplasty associated with tibial tubercle osteotomy, achieving a comprehensive correction.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30211 - Orthopaedics

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2019

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Therapeutics and Clinical Risk Management

ISSN

1178-203X

e-ISSN

—

Volume of the periodical

15

Issue of the periodical within the volume

June

Country of publishing house

NZ - NEW ZEALAND

Number of pages

7

Pages from-to

597-603

UT code for WoS article

000467079000001

EID of the result in the Scopus database

2-s2.0-85070224150