scholarly journals Method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Si Yulou ◽  
Xue Yanqin ◽  
Xing Yongjun
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Space ◽  
Flexion Contracture ◽  
Soft Tissue Release ◽  
Joint Motion ◽  
Total Knee ◽  
Better Than

AbstractTo discuss the method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing. Clinical data of 80 patients from October 2013 to December 2014 was selected with a retrospective method. All patients have undergone total knee arthroplasty. Then the X-rays plain film in weight loading was measured before and after operation and osteotomy was performed accurately according to the knee joint scores and the conditions of lower limb alignments. The average angle of tibial plateau osteotomy of postoperative patients was 4.3°, and the corrective angle of soft tissue balancing was 10.7°; the postoperative patients’ indicies including range of joint motion, knee joint HSS score, angle between articular surfaces, tibial angle, femoral-tibial angle and flexion contracture were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant; the postoperative patients’ flexion contracture and range of joint motion were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant. The effective release of the soft tissue of the posterior joint capsule under direct vision can avoid excess osteotomy and get satisfactory knee replacement space without influencing the patients’ joint recovery.

Total knee arthroplasty for valgus osteoarthritis: the results of a standardized soft-tissue release technique

2016 ◽  
Vol 24 (8) ◽  
pp. 2525-2531 ◽  
Author(s):  
Friedrich Boettner ◽  
Lisa Renner ◽  
Danik Arana Narbarte ◽  
Claus Egidy ◽  
Martin Faschingbauer
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Release ◽  
Release Technique ◽  
Valgus Osteoarthritis ◽  
Total Knee

Is Standing Coronal Long-Leg Alignment View Effective in Predicting the Extent of Medial Soft Tissue Release in Varus Deformity during Total Knee Arthroplasty?

2021 ◽  
Author(s):  
Mohammadreza Minator Sajjadi ◽  
Mohammad Ali Okhovatpour ◽  
Yaser Safaei ◽  
Behrooz Faramarzi ◽  
Reza Zandi
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Varus Deformity ◽  
Soft Tissue Release ◽  
Varus Knee ◽  
Significant Difference ◽  
Leg Alignment ◽  
Total Knee ◽  
Group 2

AbstractThe aim of this study was to assess the predictive value of the femoral intermechanical-anatomical angle (IMA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibia angle (MPTA), femorotibial or varus angle (VA), and joint line convergence angle (CA) in predicting the stage of the medial collateral ligament (MCL) during total knee arthroplasty (TKA) of varus knee. We evaluated 229 patients with osteoarthritic varus knee who underwent primary TKA, prospectively. They were categorized in three groups based on the extent of medial soft tissue release that performed during TKA Group 1, osteophytes removal and release of the deep MCL and posteromedial capsule (stage 1); Group 2, the release of the semimembranosus (stage 2); and Group 3, release of the superficial MCL (stage 3) and/or the pes anserinus (stage 4). We evaluated the preoperative standing coronal hip-knee-ankle alignment view to assessing the possible correlations between the knee angles and extent of soft tissue release. A significant difference was observed between the three groups in terms of preoperative VA, CA, and MPTA by using the Kruskal–Wallis test. The extent of medial release increased with increasing VA and CA as well as decreasing MPTA in preoperative long-leg standing radiographs. Finally, a patient with a preoperative VA larger than 19, CA larger than 6, or MPTA smaller than 81 would need a stage 3 or 4 of MCL release. The overall results showed that the VA and MPTA could be useful in predicting the extent of medial soft tissue release during TKA of varus knee.

The Impact of Intraoperative Gap Difference Between Extension and Flexion on Perception of Joint Function After Total Knee Arthroplasty: a Comparative Retrospective Study

2021 ◽  
Author(s):  
Tomohiro Okayoshi ◽  
Yoshinori Okamoto ◽  
Hitoshi Wakama ◽  
Shuhei Otsuki ◽  
Masashi Neo
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Study ◽  
Soft Tissue ◽  
Knee Joint ◽  
Predictive Factors ◽  
Knee Arthroplasty ◽  
Difference Threshold ◽  
Joint Function ◽  
Flexion Gap ◽  
Total Knee

Abstract Background: The argument presupposes that intra-operative soft tissue balance is associated with patient-reported outcome measures after total knee arthroplasty (TKA). Our aim was to assess the association between the extension-to-flexion gap and patients’ reported perception of knee joint function.Methods: This was a retrospective study of 60 cases of primary cruciate-retaining TKAs performed for the treatment of medial-compartment knee osteoarthritis, at a mean follow-up of 2.6 (range, 2.0–5.2) years. Knee perception was evaluated by asking patients whether they considered their knee joint as “natural” (grade I) or “artificial”, with or without restrictions (grades II–V). The following factors were compared between the two groups: age, sex, and the extension-to-flexion gap difference. A multiple logistic regression analysis was used to identify predictive factors of an artificial knee joint perception. A receiver operating characteristic curve analysis was used to identify cut-off values of predictive factors. Result: Compared to a natural knee joint perception (26 knees, 43%), an artificial perception (34 knees, 57%) was associated with a smaller gap difference at the distraction force of 20 lbf (p < .001), 30 lbf (p = .022), and 40 lbf (p = .038), a lower EuroQol 5-Dimension score (p = .029), and self-reported joint health (Knee injury and Osteoarthritis Outcome Score-Joint Replacement [KOOS-JR], p = .032). A gap difference <1.0 mm was a predictive of an artificial perception (odds ratio, 1.63; 95% confidence interval, 1.33–4.54; p < .001). A cut-off gap difference of 0.99 mm at 20 lbf predicted an artificial perception with a sensitivity of 81.5% and a specificity of 87.9%. Post-operative satisfaction (p < .001), KOOS-JR (p < .001), patient’s joint perception (p = .006), pain (p = .015), and EuroQol 5-Dimension (p = .032) differed between the two groups when the gap difference threshold was set to 1.0 mm.Conclusion: Careful balancing of soft tissue during TKA to achieve an extension-to-flexion gap ≥ 1.0 mm can improve patients’ perception of knee joint function and quality of life.

scholarly journals Proximal Fibular Osteotomy – Simplest and Most Effective Mean to Delay Total Knee Arthroplasty

2021 ◽  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Joint Space ◽  
Medial Compartment ◽  
Knee Score ◽  
Fibular Osteotomy ◽  
Number Of Patients ◽  
Total Knee

Background: Osteoarthritis involves degeneration of articular cartilage seen with increasing age. The knee joint, the most common joint that falls prey to attacks of osteoarthritis, has 30% incidence in population above 60 years. Total knee arthroplasty (TKA) is the main surgical option for orthopaedics. Though it corrects the deformity and relieves pain, yet it is not the treatment of choice in younger population. This study aimed to validate the effects of proximal fibular osteotomy (PFO) as a newer technique in managing medial compartment knee osteoarthritis. Methods: The diagnosed patients for medial compartment knee joint osteoarthritis were selected for study from Dr. Ziauddin University hospital of Karachi. Excluded were aged less than 40 years, or with BMI more than 30, and patients with tri-compartmental arthritis. Medial and lateral joint spaces along with Oxford knee score were measured and recorded pre- and post-operatively. Patients underwent PFO after giving written and informed consent. Results: Total number of patients selected was 30 for this study; 21 (70%) females, and 9 (30%) males (mean age 58.8 years). Mean pre-operative measured medial joint space on standard antero-posterior (AP) radiograph was 0.442± 0.04 cm. Mean recorded pre-operative Oxford knee score was 23.87±3.74 mm. Improvement was observed in mean postoperative medial joint space to 0.572± 0 .066 cm and mean post-operative Oxford knee score to 40.2±5.8mm. Conclusion: This study concludes that PFO significantly improves joint function in patients with medial compartment osteoarthritis knee and may delay the need for total knee arthroplasty, if carried out at an appropriate stage. Keywords: Osteotomy; Osteoarthritis; Total Knee Arthroplasty.

scholarly journals Modified Medial Gastrocnemius Myocutaneous Flap Technique for Knee Joint Coverage after Total Knee Arthroplasty

2021 ◽  
Vol 17 (1) ◽  
pp. 67-71
Author(s):  
Dongseok Kim ◽  
Junhyung Kim ◽  
Woonhyeok Jeong ◽  
Taehee Jo ◽  
Jaehoon Choi
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Myocutaneous Flap ◽  
Perforator Flap ◽  
Medial Gastrocnemius ◽  
Soft Tissue Defects ◽  
Total Knee ◽  
Tissue Defects

While there are many reasons the medial gastrocnemius flap is often the favored treatment for soft tissue defects around the knee area, this flap has some disadvantages. Reduced volume at the distal part of the flap and a short reach complicate provision of sufficient coverage for soft tissue defects superior to the patella and the lateral knee. In order to overcome these shortcomings, we modified the typical surgical technique by combining a medial gastrocnemius muscle flap and a medial sural artery perforator flap. This approach was applied to four patients who had developed deep infections and skin and soft tissue defects around the knee joint after total knee arthroplasty. The surgeries were successful. Dead space was well-filled and wounds healed without complications in all patients. This modified medial gastrocnemius myocutaneous flap provides a new option for treating challenging skin and soft tissue defects caused by deep infection after total knee arthroplasty.

Effect of Soft Tissue Releases on Joint Space Opening in Total Knee Arthroplasty

2016 ◽  
Vol 31 (12) ◽  
pp. 2912-2916 ◽  
Author(s):  
Timothy A. Burkhart ◽  
Kevin I. Perry ◽  
Emily Dobbin ◽  
James Howard ◽  
Brent Lanting
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Joint Space ◽  
Total Knee
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