Correction osteotomy for bilateral varus knee deformity caused by premature epiphyseal closure induced by hypervitaminosis A: a case report

Purpose: To evaluate the integrity of lateral soft tissue in varus osteoarthritis knee by comparing the mechanical axis under varus stress during navigation-assisted total knee arthroplasty before and after compensating for a bone defect with the implant. Methods: Sixty-six knees that underwent total knee arthroplasty were investigated. The mechanical axis of the operated knee was evaluated under manual varus stress immediately after knee exposure and after navigation-assisted implantation. The correlation between each value of the mechanical axis and degree of preoperative varus deformity was compared by regression analysis. Results: The maximum mechanical axis under varus stress immediately after knee exposure increased in proportion to the degree of preoperative varus deformity. Moreover, the maximum mechanical axis under varus stress after implantation increased in proportion to the degree of preoperative varus deformity. Therefore, the severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, regression coefficients after implantation were much smaller than those measured immediately after knee exposure (0.99 vs 0.20). Based on the results of the regression formula, the postoperative laxity of the lateral soft tissue was negligible, provided that an appropriate thickness of the implant was compensated for the bone and cartilage defect in the medial compartment without changing the joint line. Conclusion: The severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, even if the degree of preoperative varus deformity is severe, most cases may not require additional procedures to address the residual lateral laxity.

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Arthroscopy-Assisted Computer Navigation in High Tibial Osteotomy for Varus Knee Deformity

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700112 ◽

2009 ◽

Vol 17 (1) ◽

pp. 51-55 ◽

Cited By ~ 9

Author(s):

WN Lo ◽

KW Cheung ◽

SH Yung ◽

KH Chiu

Keyword(s):

High Tibial Osteotomy ◽

Computer Navigation ◽

Mean Deviation ◽

Tibial Osteotomy ◽

Open Wedge ◽

Varus Knee ◽

Knee Alignment ◽

Knee Deformity ◽

The Mean ◽

Open Wedge Hto

Purpose. To assess the accuracy of knee alignment after high tibial osteotomy (HTO) for varus knee deformity using arthroscopy-assisted computer navigation. Methods. Six men and 4 women aged 47 to 53 (mean, 49) years underwent medial open wedge HTO for varus knee deformity and medial unicompartmental osteoarthritis using arthroscopy-assisted computer navigation with fluoroscopy. Patients were followed up for a mean of 23 (range, 11–32) months. Intra- and post-operative leg alignments were compared. Results. The mean postoperative coronal plane alignment was 2.7 (range, 1–4) degree valgus; the mean deviation from intra-operative computer images was one (range, 0.1–1.9) degree; 5 knees had less valgus in the postoperative radiographs than the intra-operative computer images. Conclusion. Despite being more technically demanding, time consuming, and costly, arthroscopy-assisted computer navigation is safe, accurate, and reliable for HTO.

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Treatment of varus knee combined with extra-articular deformity with medial condyle sliding osteotomy during total knee arthroplasty: a case report

Annals of Joint ◽

10.21037/aoj.2016.09.03 ◽

2016 ◽

Vol 1 ◽

pp. 23-23

Author(s):

Hao Chen ◽

Lin Guo ◽

Ran Xiong ◽

Lingchuan Gu ◽

Jiangming Luo ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Case Report ◽

Knee Arthroplasty ◽

Varus Knee ◽

Medial Condyle ◽

Total Knee

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Clinical Manifestations of Hypervitaminosis A in Human Gingiva: A Case Report

Journal of Periodontology ◽

10.1902/jop.1984.55.8.474 ◽

1984 ◽

Vol 55 (8) ◽

pp. 474-476 ◽

Cited By ~ 4

Author(s):

A. C. de Menezes ◽

I. M. Costa ◽

M. M. El-Guindy

Keyword(s):

Case Report ◽

Clinical Manifestations ◽

Hypervitaminosis A ◽

Human Gingiva

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Hypervitaminosis A: A Case Report

PEDIATRICS ◽

10.1542/peds.69.1.112 ◽

1982 ◽

Vol 69 (1) ◽

pp. 112-115

Author(s):

Melton B. James ◽

Joe C. Leonard ◽

John J. Fraser ◽

John H. Stuemky

Keyword(s):

Case Report ◽

Vitamin A ◽

Bone Scintigraphy ◽

Medical Literature ◽

Hypervitaminosis A ◽

Diagnostic Dilemma ◽

White Girl ◽

X Ray ◽

The Public

In his textbook, Pediatric X-Ray Diagnosis, Caffey1 makes the statement that "until the whole truth becomes available to the public, all authentic cases of Vitamin A poisoning be carefully recorded and widely published in the medical literature." Since Josephs2 first described this condition in children in 1944, more than 50 cases have appeared in the literature.3 The following case, initially viewed as a diagnostic dilemma, was subsequently recognized to have typical clinical, biochemical, and rediographic changes of hypervitaminosis A. In addition, bone scintigraphy demonstrated evidence of involvement in radiographically normal areas. CASE REPORT A 5-year-old, nonimmunized, white girl was diagnosed as having measles in late April 1980.

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