osteoarthritic knee
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2022 ◽  
pp. 309-334
Author(s):  
Alexander F. Chin ◽  
Jin Han ◽  
Elise Gray-Gaillard ◽  
John Michel ◽  
Jennifer H. Elisseeff

2021 ◽  
Author(s):  
Chiara Suardi ◽  
Matteo Innocenti ◽  
Davide Stimolo ◽  
Luigi Zanna ◽  
Christian Carulli ◽  
...  

Abstract Background Knee varus alignment represents a notorious cause of knee osteoarthritis. It can be caused by tibial deformity, combined tibial-femoral deformity and/or ligament imbalance. Understanding malalignment is crucial in total knee arthroplasty (TKA) to restore frontal plane neutral mechanical axis. The aim of this study was to determine which factor contributes the most to varus osteoarthritic knee and its related surgical implications in performing a TKA. Methods We retrospectively evaluated 140 patients operated for TKA due to a varus knee. Full-leg hip to ankle preoperative X-rays were taken. Radiological parameters recorded were: mechanical axis deviation (MAD), hip-knee-ankle (HKA), anatomical-mechanical Angle (AMA), medial neck-shaft angle (MNSA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), lateral proximal femoral angle (LPFA), lateral distal tibial angle (LDTA), femoral bowing and length of tibia and femur. We also determined ideals tibial and femoral cuts in mm according to mechanical alignment technique. A R2 was calculated based on the linear regression between the predicted values and the observed data. Results The greatest contributor to arthritic varus (R=0,444) was MPTA. Minor contributors were mLDFA (R= 0.076), JLCA (R = 0,1554), LDTA (R = 0.065), Femoral Bowing (R= 0,049). We recorded an average of 7,6 mm in lateral tibial cut thickness to restore neutral alignment. Conclusions The radiological major contributor to osteoarthritic varus knee alignment is related to proximal tibia deformity. As a surgical consequence, during performing TKA, the majority of the correction should therefore be made on tibial cut.


2021 ◽  
Vol 13 (609) ◽  
Author(s):  
Lina Acevedo Rua ◽  
Marcus Mumme ◽  
Cristina Manferdini ◽  
Salim Darwiche ◽  
Ahmad Khalil ◽  
...  

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