scholarly journals Limited release medial collateral ligament technique

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0052
Author(s):  
Wang Jinliang ◽  
Wei Xuan
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Medial Collateral Ligament ◽  
Clinical Results ◽  
Collateral Ligament ◽  
Soft Tissue Envelope ◽  
Post Operation ◽  
Total Knee ◽  
Hss Score ◽  
Varus Angle

Introduction: To explore the outcome of selective releasing medial collateral ligament in total knee arthroplasty. Hypotheses: Selective releasing technique work for knee balance and clinical results. Methods: Sixty cases of total knee arthroplasty were studied retrospectively from May,2016 to May 2017.The cases traits were as follows:22 male,38 female,age between 55 years and 83 years,the diagnosis totally OA,pre-operative and varus angle was (13.8±2.5)°,preoperative HSS score 36.5±2.9.All the cases were performed with new technique in which anterior parts of MCL was released limitedly ,posterior-lateral was released about one centimeter beneath joint line,and pie-crusting was used when it was still unbalanced.This was different from the conventional one in which a regular medial soft tissue envelope was performed. Results: Post-operation wound was I stage union.The average follou-up was nine months(6-12 months).The resudial varus angle was (0.8±1.5)°,HSS score was (86.0±3.5),which had significant statistically difference compared with the pre-op one. Conclusion: The selectively releasing MCL technique was minimally invasive and easy to learn. Good function was achieved.

scholarly journals How much improvement can satisfy patients? Exploring patients’ satisfaction 3 years after total knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiao Yu Fan ◽  
Jin Hui Ma ◽  
Xinjie Wu ◽  
Xin Xu ◽  
Lijun Shi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Minimal Clinically Important Difference ◽  
Important Change ◽  
Score Change ◽  
Patients Satisfaction ◽  
Clinically Important Difference ◽  
Total Knee ◽  
Hss Score ◽  
Varus Angle

Abstract Background Despite the innovations in total knee arthroplasty (TKA), there is still a subset of patients who do not acquire significant relief or expected satisfaction after primary TKA. However, this subgroup of patients still gains improvements more or less in terms of objective or quantified assessments after the procedure. The purpose of our study is to explore the factors that correlate with patients’ satisfaction and identify minimal clinically important difference (MCID) and minimum important change (MIC) in clinical parameters. Methods We conducted a retrospective study of 161 patients diagnosed with osteoarthritis who underwent unilateral total knee arthroplasty from January 2017 to December 2017. We collected the following parameters: body mass index (BMI), duration of disease, education level, depression state, preoperative flexion contracture angle of knee, HSS scores, 11-point NRS scores, and radiological parameters (preoperative minimal joint space width and varus angle of knee). The satisfaction was graded by self-reported scores in percentage (0–100). Results We revealed that 80.8% of patients were satisfied 3 years overall after primary TKA. HSS score change, NRS-Walking score change, age, and pre-mJSW showed significant difference between satisfied and dissatisfied group. The varus angle change revealed statistical significance according to the levels of satisfaction. Simple linear regression identified the MCID for HSS score to be 5.41 and for the NRS-Walking to be 1.24. The receiver operating characteristics (ROC) curve identified the MIC for HSS score to be 25.5 and for the NRS-Walking score to be 6.5. Conclusions In summary, we identified several factors that correlated with patients’ satisfaction independently after TKA in a long term. In addition, we revealed the minimal clinically important difference (MCID) and minimum important change (MIC) for HSS and NRS score in these patients.

Primary Repair of Intraoperative Disruption of the Medial Collateral Ligament During Total Knee Arthroplasty

2001 ◽  
Vol 83 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Seth S. Leopold ◽  
Chris McStay ◽  
Karen Klafeta ◽  
Joshua J. Jacobs ◽  
Richard A. Berger ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Medial Collateral Ligament ◽  
Primary Repair ◽  
Collateral Ligament ◽  
Total Knee

Can isolated removal of osteophytes achieve correction of varus deformity and gap-balance in computer-assisted total knee arthroplasty?

2020 ◽  
Vol 102-B (6_Supple_A) ◽  
pp. 49-58
Author(s):  
Arun Mullaji
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Medial Collateral Ligament ◽  
Knee Flexion ◽  
Deformity Correction ◽  
Computer Assisted ◽  
Cruciate Ligaments ◽  
Collateral Ligament ◽  
Total Knee

Aims The aims of this study were to determine the effect of osteophyte excision on deformity correction and soft tissue gap balance in varus knees undergoing computer-assisted total knee arthroplasty (TKA). Methods A total of 492 consecutive, cemented, cruciate-substituting TKAs performed for varus osteoarthritis were studied. After exposure and excision of both cruciates and menisci, it was noted from operative records the corrective interventions performed in each case. Knees in which no releases after the initial exposure, those which had only osteophyte excision, and those in which further interventions were performed were identified. From recorded navigation data, coronal and sagittal limb alignment, knee flexion range, and medial and lateral gap distances in maximum knee extension and 90° knee flexion with maximal varus and valgus stresses, were established, initially after exposure and excision of both cruciate ligaments, and then also at trialling. Knees were defined as ‘aligned’ if the hip-knee-ankle axis was between 177° and 180°, (0° to 3° varus) and ‘balanced’ if medial and lateral gaps in extension and at 90° flexion were within 2 mm of each other. Results Of 50 knees (10%) with no soft tissue releases (other than cruciate ligaments), 90% were aligned, 81% were balanced, and 73% were aligned and balanced. In 288 knees (59%) only osteophyte excision was performed by subperiosteally releasing the deep medial collateral ligament. Of these, 98% were aligned, 80% were balanced, and 79% were aligned and balanced. In 154 knees (31%), additional procedures were performed (reduction osteotomy, posterior capsular release, and semimembranosus release). Of these, 89% were aligned, 68% were balanced, and 66% were aligned and balanced. The superficial medial collateral ligament was not released in any case. Conclusion Two-thirds of all knees could be aligned and balanced with release of the cruciate ligaments alone and excision of osteophytes. Excision of osteophytes can be a useful step towards achieving deformity correction and gap balance without having to resort to soft tissue release in varus knees while maintaining classical coronal and sagittal alignment of components. Cite this article: Bone Joint J 2020;102-B(6 Supple A):49–58.

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