An Algorithmic, Pie-Crusting Medial Soft Tissue Release Reduces the Need for Constrained Inserts Patients With Severe Varus Deformity Undergoing Total Knee Arthroplasty

The Journal of Arthroplasty
Kaveh Goudarz MehdikhaniAlejandro González Della Valle

Abstract

We studied the need to use a constrained insert for residual intraoperative instability and the 1-year result of patients undergoing total knee arthroplasty (TKA) for a varus deformity. In a control group, a "classic" subperiosteal release of the medial soft tissue sleeve was performed as popularized by pioneers of TKA. In the study group, an algorithmic approach that selectively releases and pie-crusts posteromedial structures in extension and anteromedial structures in flexion was used. All surgeries were performed by a single surgeon using measured resection technique, and posterior-stabilized, cemented implants. There were 228 TKAs in the control group and 188 in the study group. Outcome variables included the use of a constrained insert, and the Knee Society Score at 6 weeks, 4 months, and 1 year postoperatively. The effect of the release technique on use of constrained inserts and clinical outcomes were analyzed in a multivariate model controlling for age, sex, body mass index, and severity of deformity. The use of constrained inserts was significantly lower in study than in control patients (8% vs 18%; P = .002). There was no difference in the Knee Society Score and range of motion between the groups at last follow-up. N...Continue Reading

References

Mar 29, 2002·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Zair FishkinIsrael Ziv
Oct 16, 2004·The Journal of Arthroplasty·Orhun K MuratogluWilliam H Harris
Jul 2, 2005·The Journal of Arthroplasty·John J CallaghanSteve S Liu
Sep 5, 2006·The Journal of Arthroplasty·Paul F Lachiewicz, Elizabeth S Soileau
Sep 5, 2007·The Journal of Bone and Joint Surgery. American Volume·Robert F LaPradeLars Engebretsen
Mar 18, 2009·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Peter C M VerdonkPhilippe Neyret
Sep 5, 2009·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Johan BellemansJ Victor
Nov 26, 2011·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Mitsuhiro TakedaJunko Sato
May 24, 2012·The Journal of Bone and Joint Surgery. American Volume·Morteza MeftahChitranjan S Ranawat
May 18, 2013·The Journal of Arthroplasty·R Michael MeneghiniJay R Lieberman
Apr 2, 2014·The Orthopedic Clinics of North America·Martin RocheChristopher Anderson
Oct 8, 2014·The Journal of Arthroplasty·William M MihalkoJohn L Williams

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Citations

Jul 21, 2016·The Journal of Arthroplasty·Scott R NodzoAlejandro Gonzalez Della Valle
Feb 9, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Scott R NodzoAlejandro Gonzalez Della Valle
Jul 3, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Mehdi MotififardArvin Shahzamani
Aug 25, 2018·International Orthopaedics·Roberto RossiFederica Rosso
Oct 12, 2020·International Orthopaedics·Ethan KrellAlejandro Gonzalez Della Valle
Jan 24, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Tarun GoyalArghya Kundu Choudhury
Dec 5, 2020·Clinics in Orthopedic Surgery·Satit ThiengwittayapornPichai Sansawat
Jul 20, 2021·The Journal of Arthroplasty·Said Mohamad SayahDaniel Steffens

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