Varus deformity in the proximal tibia and immediate postoperative varus alignment result in varus progression in limb al
- PDF / 1,032,899 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 30 Downloads / 171 Views
KNEE
Varus deformity in the proximal tibia and immediate postoperative varus alignment result in varus progression in limb alignment in the long term after total knee arthroplasty Yuichi Kuroda1 · Koji Takayama1 · Shinya Hayashi1 · Shingo Hashimoto1 · Takehiko Matsushita1 · Takahiro Niikura1 · Ryosuke Kuroda1 · Tomoyuki Matsumoto1 Received: 12 September 2019 / Accepted: 16 December 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose The aim of this study was to examine and evaluate the factors associated with changes in limb alignment 10 years after total knee arthroplasty (TKA). The hypothesis was that bone morphology and immediate postoperative alignment could be correlated with long-term post-operative alignment changes following TKA. Methods This study retrospectively analysed 136 consecutive primary TKA cases for varus deformity, performed from 2006 to 2008, that could be followed for at least 10 years postoperatively. Anteroposterior long-leg weight-bearing radiographs were obtained within 1 month and at least 10 years after surgery. The hip–knee–ankle (HKA) angle immediately after surgery was compared with that 10 years later; factors correlating with the change in HKA angle (δHKA) were evaluated. Results The mean HKA angles were significantly different between immediate and long-term postoperative assessments (0.1° ± 1.9° vs. 1.2° ± 2.9°, p 3° deviation from the 0° of HKA angle) (10% vs. 24%, p = 0.002). δHKA strongly correlated with a higher preoperative tibial plateau tip-to-proximal tibial shaft (TPTPS) angle, higher postoperative HKA angle, lateral distal femoral angle, and lower postoperative medial proximal tibial angle. Conclusion Varus deformity in the proximal part of the tibia, immediate postoperative varus alignment, and varus position of the femoral and tibial components may lead to varus progression in limb alignment in the long term, even 10 years after TKA; the surgeon should, therefore, weigh the risks of leaving a varus alignment during surgery. Moreover, if the preoperative TPTPS angle is high, the alignment may become varus after TKA, even in patients who have acquired neutral alignment. Level of evidence IV. Keywords Total knee arthroplasty · Long-term outcome · Alignment · Morphology · Varus
Introduction Postoperative neutral limb alignment has generally been considered a prerequisite for successful total knee arthroplasty (TKA) [6]. Despite obtaining a neutral mechanical alignment, such as a hip-knee-ankle (HKA) angle of 0° after TKA, a low patient satisfaction score of 57.5% has been reported [13]. Bellemans et al. have stated that * Tomoyuki Matsumoto [email protected] 1
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7‑5‑1 Kusunoki‑cho, Chuo‑ku, Kobe 650‑0017, Japan
a physiologically normal human has a varus alignment of > 3°, termed as constitutional varus, the incidence being approximately 32% in men and 17% in women [3]. A study further suggested that the incidence of constitution
Data Loading...
