Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic Review
Background: “Windswept” deformity (WSD) consists of a non-frequent condition in which the patient presents a valgus deformity in one knee and a varus deformity in the other. We performed a review of the available literature to aggregate the accessible data on the outcomes of bilateral knee arthropla...
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| Format: | Article |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/21/6580 |
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| author | Eugenio Cammisa Iacopo Sassoli Matteo La Verde Stefano Fratini Vito Gaetano Rinaldi Giada Lullini Vittorio Vaccari Stefano Zaffagnini Giulio Maria Marcheggiani Muccioli |
| author_facet | Eugenio Cammisa Iacopo Sassoli Matteo La Verde Stefano Fratini Vito Gaetano Rinaldi Giada Lullini Vittorio Vaccari Stefano Zaffagnini Giulio Maria Marcheggiani Muccioli |
| author_sort | Eugenio Cammisa |
| collection | DOAJ |
| description | Background: “Windswept” deformity (WSD) consists of a non-frequent condition in which the patient presents a valgus deformity in one knee and a varus deformity in the other. We performed a review of the available literature to aggregate the accessible data on the outcomes of bilateral knee arthroplasty in patients with WSD and to discuss the surgical challenges that this condition might pose. Methods: A systematic review of the literature following the PRISMA guidelines was conducted. The relevant studies between 1979 and 2021 were identified. Four studies with a total of 68 patients were included for analysis. The mean follow-up for varus knees was 3.3 years, 3.1 years for valgus knees. The quality and rigor of the included studies was assessed using the Methodological index for non-randomized studies (MINORS). Results: All the studies reported improvement in knee function following knee replacement surgery, and a reduction in axial deviation of both knees, with similar results in valgus and varus knees in terms of patient satisfaction. The most relevant data were that unicompartmental knee arthroplasty (UKA) allowed for limited axial correction with slightly inferior functional results. Kinematic alignment (KA) allowed for similar results in both knees. Conclusion: The present review shows how satisfactory results can be achieved in both knees in patients with WSD and osteoarthrosis (OA). However, the operating surgeon should be aware of the importance of the implant choice in terms of functional outcomes. In the absence of extra-articular deformities, calipered KA total knee arthroplasty (TKA) can be performed on both knees with good axial correction and functional outcome. Level of evidence: II —Systematic review of cohort studies. |
| first_indexed | 2024-03-09T18:57:23Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T18:57:23Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-19517ab7fa474659b0624f477c36fce12023-11-24T05:20:00ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011121658010.3390/jcm11216580Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic ReviewEugenio Cammisa0Iacopo Sassoli1Matteo La Verde2Stefano Fratini3Vito Gaetano Rinaldi4Giada Lullini5Vittorio Vaccari6Stefano Zaffagnini7Giulio Maria Marcheggiani Muccioli8Orthopedic Unit, Imola Hospital, 40026 Imola, ItalyII Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli—DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, ItalyII Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli—DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, ItalyII Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli—DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, ItalyII Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli—DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, ItalyUOC Medicina Riabilitativa e Neuroriabilitazione, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, ItalyII Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli—DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, ItalyII Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli—DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, ItalyII Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli—DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, ItalyBackground: “Windswept” deformity (WSD) consists of a non-frequent condition in which the patient presents a valgus deformity in one knee and a varus deformity in the other. We performed a review of the available literature to aggregate the accessible data on the outcomes of bilateral knee arthroplasty in patients with WSD and to discuss the surgical challenges that this condition might pose. Methods: A systematic review of the literature following the PRISMA guidelines was conducted. The relevant studies between 1979 and 2021 were identified. Four studies with a total of 68 patients were included for analysis. The mean follow-up for varus knees was 3.3 years, 3.1 years for valgus knees. The quality and rigor of the included studies was assessed using the Methodological index for non-randomized studies (MINORS). Results: All the studies reported improvement in knee function following knee replacement surgery, and a reduction in axial deviation of both knees, with similar results in valgus and varus knees in terms of patient satisfaction. The most relevant data were that unicompartmental knee arthroplasty (UKA) allowed for limited axial correction with slightly inferior functional results. Kinematic alignment (KA) allowed for similar results in both knees. Conclusion: The present review shows how satisfactory results can be achieved in both knees in patients with WSD and osteoarthrosis (OA). However, the operating surgeon should be aware of the importance of the implant choice in terms of functional outcomes. In the absence of extra-articular deformities, calipered KA total knee arthroplasty (TKA) can be performed on both knees with good axial correction and functional outcome. Level of evidence: II —Systematic review of cohort studies.https://www.mdpi.com/2077-0383/11/21/6580knee arthroplastyTKAwindsweptvarus kneevalgus kneekinematic alignment |
| spellingShingle | Eugenio Cammisa Iacopo Sassoli Matteo La Verde Stefano Fratini Vito Gaetano Rinaldi Giada Lullini Vittorio Vaccari Stefano Zaffagnini Giulio Maria Marcheggiani Muccioli Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic Review Journal of Clinical Medicine knee arthroplasty TKA windswept varus knee valgus knee kinematic alignment |
| title | Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic Review |
| title_full | Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic Review |
| title_fullStr | Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic Review |
| title_full_unstemmed | Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic Review |
| title_short | Bilateral Knee Arthroplasty in Patients Affected by Windswept Deformity: A Systematic Review |
| title_sort | bilateral knee arthroplasty in patients affected by windswept deformity a systematic review |
| topic | knee arthroplasty TKA windswept varus knee valgus knee kinematic alignment |
| url | https://www.mdpi.com/2077-0383/11/21/6580 |
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