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Arthroplasty 2019
June 24-25, 2019
Volume 14
Journal of Orthopaedics Trauma Surgery and Related Research
Arthroplasty
June 24-25, 2019 | Rome, Italy
12
th
International Conference on
New concepts in medial release based on experience with varus Tka’s
Rashid Ganji
Sina Hospital, Iran
Background:
Patients with severe Varus knees is common in developing countries (i.e. Middle East) where Total Knee
Arthroplasty (TKA) can effectively resolve this issue. There are many methods to perform this medial release. However,
each technique may have implied disadvantages. For this reason, many surgeons are unable to avoid instability and stop
using semi-constrained prosthesis in this group of patients indeterminately. We have developed a new concept for this
release based on our experience in performing over 5000 surgical cases to decrease subtle instability and reach nearly 0%
use of semi-constrained prosthesis.
Methods:
Surgical procedures were accomplished by the same surgeon with measured resection technique, and cemented
posterior-stabilized prosthesis. 250 TKAs were in this study and divided them into 3 groups. First group of patients had
varus deformity up to 15 degrees, second group 15-25 degrees, and the third group over 25 degrees. The medial soft tissue
release was distinctive for each group by only releasing the deep MCL and capsule for the first group. We evaluated our
outcome based on the Knee Society Score at 2 and 6 months, and 1 year postoperatively.
Results:
Results showed that in mild deformity, there was no need for considerable release. Even in moderate deformity
with little extension release to the posteromedial corner, we can obtain good balancing. For severe deformity, the main
objective was to retain the superficial MCL as much as possible even by accepting some lateral widening of the joint. No
patient developed postoperative medial instability.
Conclusion:
This approach, considering sex, body mass index, and different soft tissue quality, as one of the alternatives
in soft tissue balancing resulted in nearly 0% use of semi-constrained prosthesis and even avoidance of subtle instability
in severe varus deformity cases (+25 degrees).
J.Orthop.Trauma Surg.Relat.Res. | Volume 14
ISSN:2449-9145