This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wang, J.-W.
Right arrow Articles by Wang, C.-J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wang, J.-W.
Right arrow Articles by Wang, C.-J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery (American) 84:1769-1774 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Total Knee Arthroplasty for Arthritis of the Knee with Extra-Articular Deformity

Jun-Wen Wang, MD and Ching-Jen Wang, MD

Investigation performed at the Department of Orthopaedic Surgery, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan

Jun-Wen Wang, MD
Ching-Jen Wang, MD
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital at Kaohsiung, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung, Taiwan. E-mail address for J.-W. Wang: lee415{at}adm.cgmh.org.tw

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Simultaneous corrective osteotomy of angular deformity and total knee arthroplasty has been considered the treatment of choice for patients with arthritis of the knee associated with ipsilateral extra-articular deformity. However, this procedure is technically demanding, and the functional outcome of the total knee arthroplasty may be jeopardized if the osteotomy fails. This retrospective study was performed to evaluate the clinical results of total knee arthroplasty combined with intra-articular bone resection, without osteotomy, in patients with extra-articular deformity and arthritis of the knee.

Methods: Fifteen patients with arthritis of the knee and extra-articular deformity underwent total knee arthroplasty with bone resection and soft-tissue balancing. All deformities had resulted from fracture malunion. There were ten uniplanar, three biplanar, and two triplanar deformities. The deformity was in the tibia in eight patients and in the femur in seven. The average angle of the femoral deformities was 15.1° in the coronal plane and 8.1° in the sagittal plane. Two femora had a rotational deformity, consisting of 20° of internal rotation in one and 10° of external rotation in the other. The average angle of the tibial deformities was 19° in the coronal plane.

Results: The duration of follow-up averaged thirty-eight months. The average Knee Society knee score improved from 22.3 points preoperatively to 91.7 points at the time of the last follow-up, and the average Knee Society function score improved from 28.0 points preoperatively to 87.3 points at the time of the last follow-up. The average arc of knee motion improved from 77.7° preoperatively to 103.7° postoperatively. The average mechanical axis of the knee improved from 22.7° of varus preoperatively to 0.3° of varus at the time of the last follow-up. Two patients had an unsatisfactory clinical result, which was not related to the total knee arthroplasty. There were no complications such as infection, ligament instability, or component loosening.

Conclusions: Total knee arthroplasty in conjunction with intra-articular bone resection is an effective procedure for patients with arthritis of the knee and extra-articular varus deformity of <20° in the femur or £30° in the tibia in the coronal plane.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
K. Bauwens, G. Matthes, M. Wich, F. Gebhard, B. Hanson, A. Ekkernkamp, and D. Stengel
Navigated Total Knee Replacement. A Meta-Analysis
J. Bone Joint Surg. Am., February 1, 2007; 89(2): 261 - 269.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
J. A. Rand
Extensor Mechanism Complications Following Total Knee Arthroplasty
J. Bone Joint Surg. Am., September 1, 2004; 86(9): 2062 - 2072.
[Full Text] [PDF]

Home page
 JBJSHome page
M. J. Archibeck and R. E. White Jr.
What's New in Adult Reconstructive Knee Surgery
J. Bone Joint Surg. Am., July 3, 2003; 85(7): 1404 - 1411.
[Full Text] [PDF]