Lateral parapatellar approach with tibial tubercle osteotomy for the treatment of non-correctable valgus knee osteoarthritis: a retrospective clinical study.

Autor: Chalidis BE; Malabar Orthopaedic Clinic, 43 The Avenue, Windsor 3181, Melbourne, Australia. Electronic address: byronchalidis@gmail.com., Ye K; Malabar Orthopaedic Clinic, 43 The Avenue, Windsor 3181, Melbourne, Australia., Sachinis NP; Malabar Orthopaedic Clinic, 43 The Avenue, Windsor 3181, Melbourne, Australia., Hawdon G; Malabar Orthopaedic Clinic, 43 The Avenue, Windsor 3181, Melbourne, Australia., McMahon S; Malabar Orthopaedic Clinic, 43 The Avenue, Windsor 3181, Melbourne, Australia.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2014 Jan; Vol. 21 (1), pp. 204-8. Date of Electronic Publication: 2013 Jun 21.
DOI: 10.1016/j.knee.2013.05.008
Abstrakt: Background: The aim of this retrospective study was to evaluate the efficacy of a lateral parapatellar approach combined with a tibial tubercle osteotomy (TTO) in patients undergoing total knee arthroplasty (TKA) with non-correctable valgus knee osteoarthritis.
Methods: We studied 53 consecutive patients (57 knees) who had a primary TKA via lateral parapatellar approach with a global step-cut "coffin" type TTO over a 10-year period. All patients had non-correctable grade II valgus deformity according to the Ranawat classification. The average age of patients was 71 years (45 to 77) and the mean follow-up was 39 months (20 to 98).
Results: Post-surgery, there was a significant improvement in knee extension (p=0.002), flexion (p=0.006), Knee Society Pain and Function Scores (p<0.001) and WOMAC Osteoarthritis Index (p<0.001). The tibiofemoral angle changed from a preoperative median value of 11 deg (10 to 17) to a postoperative value of 3.75 deg (0 to 9). Congruent patellar tracking was observed in all cases. All but one osteotomy united in a median period of 16.7 weeks (9 to 28) and no hardware removal was required. One knee developed infection treated with two-stage reconstruction. A proximal tibial stress fracture also occurred in a patient on long-term bisphosphonate therapy.
Conclusion: Lateral parapatellar approach along with TTO is an effective technique for addressing non-correctable valgus knee deformity during TKA.
(Copyright © 2013 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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